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NEW MAVEN, '. 'NN
THE SCHOOL OF
The American Health Primers.
EDITED BY W. W. KEEN, M. D.,
Fellow of the College of Physicians of Philadelphia.
This series of American Health Primers is prepared to diffuse as widely ano
cheaply as possible, among all classes, a knowledge of the elementary facts of
Preventive Medicine, and the bearings and applications of the latest and best re
searches in every branch of Medical and Hygenic Science, They are intended
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children, pupils, employees, etc.
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HEARING, AND HOW TO KEEP IT. With Illustrations. By Chas. H.
Burnett, M. D., Aurist to the Presbyterian Hospital, Professor in the Philadel
LONG LIFE, AND HOW TO REACH IT. By J. G. Richardson, M. D ,
Piofessor of Hygiene in the University of Pennsylvania.
THE SUMMER, AND ITS DISEASES. By James C. Wilson, M. D. v
Lecturer on Physical Diagnosis in Jefferson Medical College.
EYESIGHT, AND HOW TO CARE FOR IT. With Illustrations. By
Geo C. Harlan, M. D., Surgeon to the Wills (Eye) Hospital, and to the Eye
and Ear Department, Pennsylvania Hospital.
THE THROAT AND THE VOICE. With Illustrations. By J. Solis Co-
hen, M. D., Lecturer on Diseases of the Throat in Jefferson Medical College.
THE WINTER, AND ITS DANGERS. By Hamilton Osgood, M. D..
of Boston, Editorial Staff Boston Medical and Surgical Journal.
THE MOUTH AND THE TEETH. With Illustrations. By J. W. Whitb .
M. D., D. D. S., of Philadelphia, Editor of the Denial Cosmos.
BRAIN WORK AND OVERWORK. By K. C.Wood. Jr., M. D., Clin
ical Professor of Nervous Diseases in the University of Pennsylvania.
OUR HOMES. With Illustrations. By Henry Hartshorne, M. D.,of Phil
adelphia, formerly Professor of Hygiene in the University of Pennsylvania.
THE SKIN IN HEALTH AND DISEASE. By L. D. Bulkley, M. D.. 01
Yew York, Physician to the Skin Department of the Demilt Dispensary and oi
the New York Hospital.
SEA AIR AND SEA BATHING. By John H. Packard, M. D., of Phila
delphia. Surgeon to the Pensylvania and to St. Joseph's Hospitals.
SCHOOL AND INDUSTRIAL HYGIENE. By D. F. Lincoln, M. D., oi
Boston, Chairman Department of Health, American Social Science Association
" Each Volume of the 'American Health Primers" The Inter-Ocean has had the
pleasure to commend. In their practical teachings, learning, and sound sense,
the^e volumes are worthy of all the compliments they have received. They teach
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" The series of American Health Primers deserves hearty commendation. These
handbook* of practical suggestion are prepared by men whose professional compe-
tence is beyond question, and for the most part, by those who have made the sub-
ject treated the specific study of their lives."
School and Industrial
D. F. LINCOLN, M.D.,
Chairman Department of Health, Social Science Association.
P. BLAKISTON, SON & CO.,
No. IOI2 WALNUT STREET.
PART I.— SCHOOL HYGIENE.
I. — General Remarks 7
II. — Emotional and Mental Strain . . 14
III. — Food and Sleep . . . • • • '9
IV. — Bodily Growth 2 4
V. — Amount of Study 28
VI. — Exercise 34
VII. — Care of the Eyes . . . . • 4 8
VIII. — School-Desks and Seats . . . -64
IX. — A Model School-Room . . . .79
X. Ventilation and Heating . . .85
XL — Site, Drainage, etc 94
XII. — Private Schools 98
XIII. — Colleges 102
XIV. — Contagious Disease 105
PART II.— INDUSTRIAL HYGIENE.
I. — Injurious Effects of Inhaling Dusty
and Poisonous Substances . . . 107
II. — Injuries from Atmospheric Changes . 120
III. — Injuries from Over-Use of Certain Or-
IV. — Injuries from Accidents . . . -133
V. — Regulation of Hours of Labor . .136
VI. — Duration of Life in Various Occupa-
School and Industrial Hygiene.
THE period at which we live is witnessing great
changes in the theory and practice of education,
from the lowest to the highest grades. The nature
of the child's mind has been studied, his powers
gauged, and his growth measured by a Pestalozzi, a
Froebel, a Combe, a Chadwick, a Bowditch. Every-
body knows that children do not like to sit still long
at a time ; that their minds easily wander ; that they
have an instinctive dislike to certain studies. This
restlessness of mind and body, this dislike to certain
mental foods, were regarded by the old masters as
simply undesirable elements in character, to be
curbed and chained, and overcome by force of dis-
8 SCHOOL AND INDUSTRIAL HYGIENE.
cipline. The modern tendency is in a very different
direction ; it studies the natural behavior of chil-
dren, and deduces from multiplied observations cer-
tain laws regarding their natural powers and apti-
tudes, to which all educational processes are subor-
To some extent the old masters were right; curbs
have their use, and " old-fashioned " hard work ought
not to be forgotten. Nor is the newer education free
from grave faults of its own ; or let us rather say,
that right principles are not yet fully adopted by all.
A great many teachers have found that emulation is
a more than effectual substitute for the rod. This is
one of the most characteristic of modern improve-
ments ; but its potency has no sooner been discov-
ered than it is abused, and many a promising child,
within the past thirty years, has wrecked his physi-
cal endurance for life, or has permanently enfeebled
his mind by excess of study performed under the spur
of emulation or an unregulated sense of duty.
No theory of education is satisfactory thst does
not claim the whole child. The State must leave a
great many things to the parents in education ; but
it is her duty to attend to such things as parents can-
not be made to attend to. Religion is a thing which
the State does not try to teach, assuming that parents
and churches can more safely attend to it ; but mo-
rality must be taught at school. All schools assume
GENERAL REMARKS. g
the immorality of falsehood and brutality, and the
paramount obligation to perform school-tasks. It
would be easy to take classes of ignorant, poor chil-
dren, before they reach the age of street ruffians
(which so many become after leaving the public
school), and not only to show them, but to convince
them of the necessity for truth, peaceable behavior,
and respect for law, and of the necessary connection
between duty or work performed and the prosperity
of one and all.* In our public schools, I think this
is hardly attempted. And yet, setting aside the
moral, and assuming the sanitarian, ground as our
sole basis, it is assuredly true that these branches of
morals, and others that might be named, as punctu-
ality, cleanliness, politeness, and faithfulness to en-
gagements, are not things which can be neglected.
Again : the food and sleep of the child are mainly
beyond the control of public schools. They are not
wholly so, however; and it is a teacher's duty to
discourage working in improper hours. Still more
imperatively is it his duty to regulate the child's
needs in school-time, to see if he is faint from want
of food,- to encourage and teach good habits, and to
give opportunity for bodily exercise.
No lower aim should content the child's teacher
than that of improving all his faculties and powers —
* For admirable illustrations of this kind of teaching, see
George Combe's " Education," edited by Wm. Jolly, 1879.
IO SCHOOL AND INDUSTRIAL HYGIENE.
bodily, mental, and moral. The teacher should feel
his obligation to his school a patriotic one, as
did the Athenian office-holder, who swore, " a^iva
rtapaiaoeiv," to transmit the city over which he ruled
better than when it was put into his hands ; better in
It is my strong conviction that this can be done
by the public or the State to a greater extent than is
The word "culture" is as badly abused to-day as
the word " sentiment " was a century ago. For vast
numbers of our people, the pursuit of culture resolves
itself into the reading of books and the looking at
pictures and bric-a-brac for the purpose of talking
about them. We can easily widen this notion. The
culture (or development) of children certainly means
something better than this. But how much wider
and better ? It is preposterous to educate all children
in all branches of knowledge. We are already trying
to do too much in that direction ; but it is equally
preposterous to omit from culture the development of
physical endurance, moral soundness, and a good
practical judgment. In the case of myriads of poor
children who leave school at the ages of ten or
twelve, the opportunities for doing this are indeed
limited — and are made so by our absurd practice of
making excessively large classes ; but the State should
never lose from mind the object of training these
GENERAL REMARKS. I I
children up to men and women. As regards those
whose education is superior and protracted, there is
a full opportunity for developing power and self-con-
trol. How do we give a young man power to fight his
way in the world ? We put him into a school which
teaches only the brain, and only a corner of that.
When he is thirty years old, he will, assuredly, not
be groaning that his tutors gave him but too imperfect
an acquaintance with the Greek lyrists, or Visigothic
numismatology; he will probably be wondering (if
he is an active American) whether it pays to know
all that ; and at forty he will have discovered that
the one thing which does pay in this life is life itself;
that vital force and endurance and a good digestion
are what are needed, as much as anything from books,
to insure success in life. The President of Harvard
College states this more strongly still.
The element of self-control and guidance, in cul-
ture, is quite as much a moral as an intellectual one.
The boy is taught how to control his hand in writing
or playing, his voice in speaking or singing, his
organ of language in writing theses. He is not so
taught in regard to the use of his moral faculties, his
affections, emotions, and passions ; nor is he shown
how a want of self-control, whether in the form of
caprice, indolence, good-nature, affection, or ambi-
tion, or even when veiled under the aspect of duty,
may take away the half of the value of his talents
12 SCHOOL AND INDUSTRIAL HYGIENE.
and knowledge. Perhaps these remarks would be
more forcible if applied to girls and young women,
in whom self-restraint is not commonly thought a
necessity, and the feelings naturally take the place of
All that can be said against over-study must be re-
versed when we speak of moderate and rational study.
Overwork ought not to be allowed, on the one hand ;
and on the other, indolence must not be permitted.
It is little to say that study ought not to be allowed
to injure the health. We may say much more : it is
capable of improving health ; and for many persons
it is an indispensable means of health. A child who
has been kept at suitable tasks unconsciously misses
them when they come to an end. Civilized and
reading beings (I assume that a civilized, awakened,
informed, and interested mind is a desideratum !) must
have something for the mind to work upon, or they
fret themselves with ennui. Much study may be a
weariness to the flesh ; it may give dyspepsia by being
allowed to encroach on physical duties ; but when a
person has learned to hold the proper proportion be-
tween these two, there is nothing that he finds more
conducive to peace, satisfaction, and comfort. This
pleasant result always follows when one has accom-
plished work which he is fitted for ; and to deny an
individual his intellectual exercise is as truly a dam-
age to the body as is the deprivation of physical ex-
GENERAL REMARKS. I 3
ercise. For want of accustomed mental stimulus and
work, many a man (it is an old story) has found that
his retirement from active business was his death-
School-life, however, seems to have some injurious
effects on the health and growth of some children.
Very often it is not the school that injures a child,
but the fact that the child is living in a city and has
no place to run out-of-doors. Very often it is not
study at all that hurts, but study in hot or close or
badly-lighted rooms ; or study may be in excess of
the powers of the system. Such points as these will
receive our present attention.
EMOTIONAL AND MENTAL STRAIN.
EMOTIONAL STKAIN.— Teachers are fully aware
that this is a fluctuating factor in each child, de-
pendent on the weather, fatigue, excitement, and
Of these circumstances, those which affect the
equilibrium of power are among the most import-
ant. There is a large class of irregular mental or
emotional states which are unfavorable to the com-
plete health and steady activity of the mind. The so-
called depressing emotions — timidity, despondency,
anxiety, and discontent — often interfere with the
mental health, producing actual and very marked
lowering of the powers of execution. No scholar
ought to be allowed to remain under the influence of
them. It is the teacher's place to find out the cause,
and remove it if possible. In a certain number of
cases, they may be due to unkindness or neglect com-
ing from the teacher or the playmates. A neglect to
award merited praise either wounds or hardens the
one who feels the injustice. Again, all these de-
EMOTIONAL AND MENTAL STRAIN. 1 5
pressed states may be simply a sign of over-work,
want of exercise, bad air, want of sleep or food,
A child must not be spared all that is irksome.
Quite the contrary of this, the performance of irk-
some duty is one of the best lessons taught in school.
But it is undesirable that he should feel the object
of his study a worthless one, or should find his best
efforts unsuccessful. I venture to suggest that, in
these respects, the teacher needs as much of our
sympathy as the scholar. Too much drudgery is
laid upon her in correcting exercises, looking over
examination books and papers, making up averages
of marks, weekly and monthly reports, and other
"school statistics." It is hard and unsatisfactory to
have to give hours of the time needed for mental re-
freshment to the production of a few numerical re-
sults, which are probably destined to lie idle on a
Mental Strain. — There is a great deal of harm
done by excessive urging or over-driving of children
in school, as the reader must be aware. Yet, on the
other hand, there are many scholars whose natures
need this urging, and are not properly developed with-
out it. If a given degree of "pressure" seems to
the teacher's judgment moderate, how shall it be
decided to be e<tessive by persons who are not wit-
nesses ? Who is a better judge than the teacher of
l6 SCHOOL AND INDUSTRIAL HYGIENE.
what constitutes a fair amount of work ? In reply, it
should be said that a parent knows more about a
child, in the generality of cases, than a teacher.*
It is a parent's eye that can best see when the child
is "unlike himself;" and the parent is justified in
feeling anxiety whenever the child loses sleep and
the desire for food and play.
The means by which children are urged are well
known, consisting of credits, rank, prizes, public ex-
hibitions, and the moral influence of a teacher of
strenuous disposition. It will not do to condemn
all of these at once, for they have arguments in their
favor. But, as a general thing, the giving of prizes,
or at least public displays upon the stage, may safely
be forbidden in the case of girls as useless, if not
harmful. Their nervous system responds too quickly
to such stimuli.
If there be novels which do harm " by giving false
views of life," are there not schools for girls which
do precisely the same thing, by the excessive im-
portance which they allow the pupils to attach to a
paltry gift, or, far worse, to success in beating
The scholar's future health cannot but be bene-
fited by an effort to conquer indolence ; but — to re-
turn to our chief point — children ought in some cases
* Especially if the child be one among fitty-six, who remain
only five months with one teacher.
EMOTIONAL AND MENTAL STRAIN. \-J
to be allowed to seem indolent, for reasons elsewhere
indicated ; and it is palpably unsafe to subject all
scholars to an equal pressure.
"Over-driven" children will often study late and
sleep poorly ; they then rise late, dress in haste, and
rush for school in dread of a mark for tardiness, often
not pausing to sit down at the breakfast-table. They
thus enter on the day's work with an exhausted and
irritable system, which does not have a chance during
the forenoon — so taken up is it with school-thoughts —
to remember its need for repair and rest. The lunch-
eon-basket probably contains food suited to attract
a jaded system and to produce dyspepsia — cake and
pie and doughnuts. The child finishes the school-
tasks, and goes home with an armful of books and an
aching head — in need of food and rest and play, but
hardly aware of either, and intent simply on learning
the next day's lessons. There is no recovery from
this strain, for the lessons are not learned until bed-
time, when the experience of the day before is re-
peated, and so on day after day until the fixed term
This over-work is unfortunately apt to occur at the
very time of the year when the system is least able to
bear it. The "exhibitions," the closing examina-
tions, and the stress of the struggle for prizes, come
in the months of April, May, and June, when the
body craves fresh air and the eyes long for green
1 8 SCHOOL AND INDUSTRIAL HYGIENE.
fields ; when, too, the powers of the system begin to
flag from the withdrawal of the stimulus of cold,
which has kept them strung up to a higher pitch all
the winter. This constitutes a very serious objection
to the present system of school-exhibitions. It is
needless to say that teachers are not exempt from this
FOOD AND SLEEP.
THIS is the place to finish what needs to be said
regarding food and sleep.
The logical connection is quite obvious. Study is
a consuming of certain materials contained in the
brain and the blood ; food and sleep are the means
by which this loss is made good, and the mind placed
in a fit condition to resume work. The system of a
child who is studying to excess is becoming exhausted ;
it loses its powers in various directions ; the muscu-
lar endurance may be enfeebled ; the digestion is very
apt to fail ; appetite for food is lost, with the power
to digest food; and sleep is very apt to be poor. It
is pretty safe to say that a child who eats and sleeps
well is not much over-driven. There is a natural
antagonism between active study and active digestion.
A nourishing meal indisposes a healthy person to ac-
tive mental exertion ; and, vice versd, active study or
mental excitement takes away appetite, or at least
enfeebles the digestive power for a time. What we
say of hard study is equally true of hard play. After
20 SCHOOL AND INDUSTRIAL HYGIENE.
hard study or play there should be an interval for
relaxation or cooling-down before a meal is eaten.
Nothing could be more injudicious than a programme
which allows only one hour for dinner, following a
forenoon of study, and followed by an afternoon of
study. If it be thought desirable for young adults to
make the day as full as possible, it will be much better
to have an intermission of two hours at noon-time.
And persons not adults should always obey a rule
which places an hour's interval between dinner and
study, and at least half an hour between breakfast
or tea and study. All the meals must be nourishing,
and stimulants, such as tea, or coffee in particular,
should form no part of them. If the proper amount
of sleep is had, there is very little time for study in
the evening. The child should sleep ten hours at
the age of twelve years; nine hours at the age of
fourteen or fifteen ; and eight hours at the age of
seventeen or eighteen. It is not necessary that he
should indulge in the habit (salutary for many adults)
of taking a nap after meals.
At the "Smith College," at Northampton, Mass.,
the young ladies are expected to be in bed at ten
o'clock, and are strongly advised not to rise before
six o'clock. The students are of the usual "college
age," say from eighteen to twenty-one.
Study or exercise before breakfast is not generally
to be allowed ; it will do harm to many children.
FOOD AND SLEEP. 21
Excessively long intervals between meals are of
course to be avoided, or to be broken by solid lunch-
eons. If the above amount of sleep be allowed,
there will not be time for more than three regular
meals and a lunch.
Late dinners are apt to interfere with children's
sleep ; if, for instance, the family meal is from six to
seven, and the children go to bed from eight to nine.
A hearty, comfortable dinner about the noon-time is
much better. It is perfectly true that the afternoon
session is likely to be rather a sleepy one ; this should
induce the judicious teacher to shorten the session,
and to pl%fer manual tasks (writing, drawing, etc.)
rather than those that call for thought. Afternoon
lessons add very little tothechild'sstock of knowledge.
Is there an antagonism between food and study?
Is the mind paralyzed by the contact with the gross
material aliment ? If it be so, why not make the
practical inference, and reduce the amount of food in
order to study better? This proposition, insane as
it looks to one who understands the physiological law
of our living, is no doubt seriously acted upon by
many ambitious scholars. To such I would say —
though with small hope of being heard — that it is no
disgrace to the mind that it is attached to a body.
Its Creator has willed it so, and for this life it must be
so. To give a body insufficient food, and to exact
a full task from the brain, is slow suicide. The nour-
22 SCHOOL AND INDUSTRIAL HYGIENE.
ishment goes to the brain, while the rest of the body
grows puny, and the foundation of slow diseases,
such as consumption, is often laid. True, there have
been men and women with whom sedentary habits
and a spare diet have agreed perfectly ; but with most
men and women the result is dyspepsia, melancholy,
and a tendency to consumption or insanity ; and as
to children, or persons under twenty, a sedentary life
with spare diet is a pure absurdity. There are telling
maxims, indeed, insisting that we should rescue hours
from the night and add them to our lives, and com-
paring sleep to death :
" Stulte, quid est somnus, gelidse nisi mortis imago ?"
but, before you acknowledge their force, go and look
at the sleep of a healthy child. If you are alarmed
at being drowsy after eating, recollect that the bright-
est fire is dulled for a little while after fuel is put on.
In connection with institutions for large boys and
girls, — "colleges, ' ' as they are sometimes called, — it
may be desirable to establish a cheap lunch-counter,
which furnishes an inducement to eat solid and whole-
some food rather than a stale mess brought from
homes at great distances.
Americans, in general, eat a great deal of trash.
They are brought up to it. The subject is rather a
wide one, but it may be of service to indicate what
is not trash: A plenty of roast and less of boiled
FOOD AND SLEEP. 2$
meat; a few soups made secundum artem; a fair va-
riety of plain vegetables ; an occasional treat of the
best fruit, with abundant supplies of apples ; good
bread of more than one sort ; a daily and abundant
ration of the simplest and most strengthening food,
such as oatmeal or Indian-meal mush, with milk;
and, for drinks, water, milk, coffee which contains as
little of the original bean as possible, tea that is not
too strong, or diluted cocoa. Such a dietary, without
the compounds commonly used for dessert, but aided
by fresh air, sunlight, and plenty of play, makes
healthy children. Fish and eggs and milk are also
necessary, but should not be eaten under the impres-
sion that they " make brain."
The boarding-schools of our country have a great
opportunity for implanting habits of simple and whole-
some living. If such schools furnish unwholesome
diet, they do it in imitation of the ordinary habits
of society. In a well-conducted school, on the other
hand, — where enough of the best and simplest is
given, — it is not uncommon for pupils to come from
the indulgences of home and holidays dyspeptic and
flabby, and to become brighter and stronger as soon
as they are subjected to the regimen of school.
IF youth be a formative period, whose product is
simply the adult person, then, surely, that period
v/hen formation is most rapid, — when a new being
par excellence is developing, — deserves the greatest
respect and care. In the case of boys, growth goes
on at a nearly uniform rate until manhood. Girls,
however, concentrate a great deal of growth in a
few years. They are shorter and weigh less than
boys until the age of eleven or twelve, when they
suddenly shoot beyond them, and, for about three
years, continue decidedly taller and heavier, after
which they resume the former relative position.* It
would seem reasonable to suppose that girls at this
age are less capable of mental application than boys;
for it is a general rule of Nature, that when a great
demand is made on the system by one set of func-
tions others must remain in comparative abeyance,
* Prof. H. P. Bowditch, in " Eighth Annual Report of Mas-
sachusetts State Board of Health."
BODILY GROWTH. 2%
and that when growth is very rapid, mental action is
proportionally less so. If girls are often found
quicker and brighter than boys at this age, it may,
nevertheless, be questioned whether it is right to
allow them to come in competition with boys ; for
pluck and vivacity are not, necessarily, evidence of
After this age — that is, about fourteen and fifteen,
in most cases — comes the time when girls are under-
going a change which affects the whole system in a
different way from mere rapidityof growth, — achange
which, if effected quietly and normally, may be said
to have laid the foundation of the happiness and
health of an entire life. At this period, if at no
other, a girl should be protected from the excitement
of "society" and late hours, and should receive the
support and steadying which regular habits of study
impart. It is a more directly practical thing to say
that she ought to be treated with leniency at certain
times; her work should be lightened, her errors ex-
cused, her inattention or unreadiness overlooked, and
absence from school allowed if requested.
Many young girls have grown up to be strong and
useful women, and have never been aware that their
mental powers were less under control than those of
boys of their own age, — their school-fellows, — or that
there was any physical necessity for their studying less
than, or differently from, their brothers. Especially
26 SCHOOL AND INDUSTRIAL HYGIENE.
is this true of country girls brought up without the
excitements of society.
The late Dr. E. H. Clarke, of Boston, was of the
opinion that our system of public school education
was ruining the health of vast numbers of young
women, by compelling them to study to excess, par-
ticularly at the monthly period. His opinion was
vigorously stated in a little book, published a few
years since, entitled "Sex in Education." Equally
vigorous counter-statements were made in the books
called "Sex and Education," "No Sex in Educa-
tion," "The Education of American Girls," and
in other places; and quite a salutary storm arose,
which has resulted, it may be hoped, in leaving the
public impressed with the importance of the subject,
if nothing more.
I would here refer the reader to two of the follow-
ing chapters — that on Amount of Study and that on
Exercise. It seems to me fair to say that the growing
girl would hot generally suffer from her studies if
they were restricted within the limits hereafter sug-
gested, and if her physical development were cared
for properly. A healthy girl — such as nine out of
ten ought to be — need not suffer in health from reg-
ular attendance on school for three or four or five
hours a day, ;/ she is protected from "society" and
given a fair chance to grow strong. The harm is
done when a girl goes to the theatre or concert, and
BODILY GROWTH. 2"J
appears the next morning in school with a worn and
tired look and two great circles around her eyes.
The harm, indeed, is done long before, when she
first comes to live in a city where public parks are
thought unsafe for her to walk in, and where play in
the open air (except for "children" — that is, very
small girls) is an impossible or a forbidden thing.
It begins with that substitution of artificial for natu-
ral enjoyments, of society and its excitements for
sports, of adult for childish interests, which is char-
acteristic of city life. Many such girls are thought
to be overworked if they lose their color, while study-
ing four or five hours a day, at the age of fifteen.
AMOUNT OF STUDY.
EXCESS of mental application is any amount
which interferes with the vegetative functions,
i. e., anything which, by its intensity or long continu-
ance, or by any peculiarity of its own, interferes with
digestion, sleep, nutrition, repair, or development.
As the reader is perfectly aware, the cell-structure
called brain is in need of constant repair, equally
with other structures; and this repair is effected by
processes termed "vegetative."
Muscles, stomach, and brain equally require vege-
tative activity in order to keep them in condition ;
and each may suffer from over-activity without im-
pairing the health of the others. But, in general,
overwork of one tells disadvantageously upon all,
and an unsound or overburdened mind is apt to act
like a burden upon the body.
The amount of work to be assigned must be de-
termined empirically, and we have no right to say of
a given person, in advance of experience, that he is
capable of doing a certain amount of work. But we
AMOUNT OF STUDY. 29
can, as the result of experience, give an approximate
statement of the amount which is suitable to the av-
erage person at a given age.
As has been said before, children can be aroused
by modern methods to a great spontaneous activity
of mind, which contrasts strongly with the listless
and reluctant attention of old-fashioned schools.
The effect is obtained by adapting the instruction to
the child's capacity and nature. The kindergarten
system is one of the most striking instances of this.
I do not mention it either for praise or blame, but
simply in order to point out the fact that, under the
most favorable circumstances — cheerfulness, pleasant
and varied tasks, sympathy, and wholesome surround-
ings — a child at the kindergarten age has not the
power to bear more than two or three hours of these
tasks in a day consistently with health. If pursued
longer, the work becomes too exciting.
The late Mr. Edwin Chadwick, of England, is the
chief authority for a definite statement of the num-
ber of hours that a child should be allowed to do
school-work. His statements are based on long and
patient observation, and numerous inquiries made of
teachers whose attention was especially called to the
point ; and I do not think that any one has seriously
attempted to refute his views, which were published
a number of years ago.
In the first place, he points out the obvious inabil-
30 SCHOOL AND INDUSTRIAL HYGIENE.
ity of the little child to pay attention for a length of
time consecutively. The mind, like the body, must
be in a continual change ; the efforts made must re-
semble play in spontaneity, rapidity, and variety.
Sedentary occupation is an enforced necessity with
most adults, to some extent ; but it is always to be
considered as involving possible danger, and for a
little child is almost out of the question. His brain
is imperfectly developed ; the power of attention is
perfect, but incapable of sustained efforts ; the mind
refuses to work long in one direction, as the body re-
fuses to stand or sit still. There are certain classes
of work which are utterly beyond his power ; and yet
there is no doubt at all that a little child learns as
much, if not more, in a year as an adult student.
But he learns it in his own way, and it is not book
Let the adult reader try to attend to a new subject ;
let him take, for example, a treatise on metaphysics,
or anatomy, or vital statistics, or a "Student's Gib-
bon," or some other work which demands close at-
tention ; let the work be unfamiliar, not beyond his
comprehension, not too interesting, and let him see
how soon his mind begins to flag in the effort to
master the text, as if it were a lesson to be recited.
He will find, perhaps, at the end of an hour, not that
the subject is merely uninteresting, but that his mind
does not take hold of it as sharply as when he began ;
AMOUNT OF STUDY. 3 I
perhaps, if he is " tough," he can stand two hours.
This, by the way, is quite a different thing from an
irresponsible, leisurely reading of the brilliant narra-
tion of a Parkman or a Froude.
If an adult can apply himself to the acquisition of
knowledge in one direction for only one hour (and
how much longer can an audience listen to a lecture?),
the child can evidently do very much less. At the age
of from five to seven he can attend to one subject — a
single lesson — for fifteen minutes ; a child from seven
to ten years of age, about twenty minutes ; from ten to
twelve years, about twenty- five minutes ; from twelve
to sixteen or eighteen years, about thirty minutes.
The total of daily work corresponds with the limits
of a single effort. Ten hours' work is a maximum
average for young men ; and there is a regular grad-
ation from this down to two and a half or three hours
for children under seven.
The most vigorous and healthy young men are se-
lected for West Point, and they are severely win-
nowed by the work required of them. They are
excluded from dissipation and general society ; their
active bodily exercise, their regular diet and sleep,
and the healthful climate of the place, leave nothing
to be desired. They have ten hours a day for the six
cold months ; in summer much less. In our colleges,
where the students are not picked for their physique,
32 SCHOOL AND INDUSTRIAL HYGIENE.
the average actual work (study and recitation) among
those who are faithful to their work will not probably
exceed eight or nine hours, as far as my observation
In high-schools, during the period of rapid growth
and sexual development, a lower figure must be as-
sumed ; and it seems certain that five hours, or, under
the most favorable circumstances, six, are all that
should be required. The ages usually range from
twelve to seventeen.
Below the age of twelve years, four hours are prob-
ably sufficient ; below ten years, three or three and a
half; below seven years, two and a half or three
In England a very large number of children (over
100,000, at my latest information) are sent to school
on the so-called half-time plan. This plan is the
result of an attempt by the Government to suppress
the evils of juvenile labor in manufactories. The
children attend school about three hours a day during
the school-year, and those hours are taken out of
their factory-time. It is found that children thus
taught make as good progress as those who attend
school six hours a day. This result is probably a
mixed one, due, partly, to the beneficial effects of
change of occupation, and partly to the fact that six
hours are clearly beyond the limit of profitable men-
tal exertion. Something must also be ascribed to the
AMOUNT OF STUDY.
regularity of attendance in half-time schools, which
is enforced under the penalty of exclusion from the
At what age should a child be sent to school ?
The kindergarten does not injure a child of four
years unless carried to the point of over-excitement,
which, I believe, is not often done. The common
primary school, however, is decidedly objectionable.
It takes very young children (six years of age), and
compels them to remain twice as long as is good for
them. By great ingenuity and vivacity, a teacher
can keep them going upon various studies for three
hours. This is all that is reasonably possible, yet
the children are expected to come back for a second
session in the afternoon. A school conducted by set
lessons and recitations— a mimic grammar-school, in
fact — should not receive children under seven or
eight years of age.
* See Reports of the Massachusetts Bureau of Labor for
1871, 1875, and 1878.
IN spite of all that may be justly said of the value
of intellectual pursuits in promoting health, it
remains true that a great .many brain-workers are
exposed to a serious danger. The effects of unre-
lieved work with the mind are not always easy to
trace. In the case of teachers, the system gets so
gradually used to a low tone of physical life that one
forgets the sensation of health, loses a standard for
self- comparison, and does not become aware that
ground is really lost until matters are already serious.
To a person in vigorous health, with strong muscles,
who feels his temper and digestion giving way under
the influence of teaching, heavy gymnastics or field-
sports of an active sort may be recommended. To
the less vigorous or muscular person, and to most
women who teach, a daily walk of from half an hour
to two hours is necessary. It should be taken in
company ; care should be left at home ; new scenes
sought, and the object should be less to get fatigue
by great exertions than to give the mind an oppor-
tunity to take a view of life which school-work does
not give. One chief benefit of walking is that it
breaks up trains of thought.
It is certainly worth while for women to cultivate
muscularity, if they can do so with safety. A great
many could walk five miles a day, and be the better
for it ; others could not : and the way to find out is
by trying. Beginning with two miles, one may grad-
ually work up to five in the course of five weeks.
Perhaps it may be necessary to restrict the amount ;
but this must be learned by trial.
Some persons, especially teachers, ought to enjoy
almost absolute rest on Sundays. Few are really
aware of the value of the Sabbath as a physical agent
of health. The teacher should so use it as to get a
sense of renewed life every Monday, and, unless in
most vigorous health, should certainly not teach in
It is difficult to state with accuracy the precise
time when the frame of the body takes a permanent
form ; it certainly varies in different cases ; but it is
plain enough that there is a great difference between
the years before twenty and those after. The re-
quirements of a growing body, it cannot be too often
repeated, are very different from those of an adult
body. We urge gymnastics upon the adult in order
to preserve the constitution ; upon the child, in order
to form it. Circumstances often forbid the systematic
$6 SCHOOL AND INDUSTRIAL HYGIENE.
pursuit of gymnastics by adults; children have, or
should have, no engagements or occupations to inter-
fere with it.
The benefits of gymnastics are of several sorts.
Children are not to practise them chiefly for the sake
of gaining great strength. They are to be used as a
means of conferring grace of movement and the out-
lines which indicate health and endurance ; of en-
larging the chest, thereby giving free play to the act
of breathing and the motion of the heart ; of strength-
ening the latter organ by degrees ; of fortifying the
muscular walls of the abdomen against rupture and
the joints against accident; of confirming the habit
of liberal consumption and ready assimilation of food
(though play is better for this object). All these are
best attained by the use of few and light apparatus ;
at least, in the commencement.
The word "calisthenics" implies the imparting
of strength and beauty. There is a proverb that
" beauty is but skin deep;" a very superficial view,
indeed. Beauty of form is not skin deep ; it depends
on the bony frame, on the development of muscles
over the bones, and on the fatty layer over the mus-
cles. A straight back may be said to be an element
of beauty ; round shoulders and a twisted spine are
an element of the opposite quality, beyond a doubt.
It is well known to physicians that a large number
of young girls in cities have a perceptible tendency
to distortion of the spine at the growing. period of
life. The case is certainly aggravated by confine-
ment in school, by want of muscular exercise, and by
improper positions in study. Boys do not exhibit
this tendency to so marked an extent; but it is a
thing to be constantly looked after in the case of
" In a school of 731 pupils at Neufchatel, 62 cases
of deviation of the spinal column were observed
among 350 boys, and 156 cases among 381 girls.
These results are further stated not to differ materi-
ally from those of examinations made in German
schools. According to Adams, in 83 per cent, of
782 pupils (649 cases), in which this deviation oc-
curred, it was towards the right — probably in conse-
quence of writing at unsuitable desks. According to
Eulenberg, in 92 per cent. (276) of 300 cases, the
curvature was also to the right. It is true that these
curvatures are not always associated with public
health, since they sometimes occur in a slight degree
to the strong and well ; and it is true, also, that they
may arise under influences not peculiar to school-life,
such as the preponderating use of one or the other
arm for any purpose. There can be but little doubt,
however, that to the habit of writing at unsuitable
desks belongs the largest share of blame.
" In the statistics which I have given, the spinal
curvatures were found to occur with much greater
38 SCHOOL AND INDUSTRIAL HYGIENE.
frequency among girls than among boys, .partly due,
no doubt, to the fact that they play fewer active
games, and are, in general, more restrained in their
movements. In a brief report of a recent meeting
at Berlin, of some of the highest authorities of Ger-
many, called together to consider the entire subject
of the school education of girls, I find a notice of
an address by Herr Raaz, principal of a school in
Berlin, in which he speaks of the common occur-
rence of these spinal curvatures in his school, and
says that he has found the use of gymnastics to be
powerful in preventing them." *
Children should have several hours of play every
day in the open air, when possible. Vigorous and
spontaneous action of this sort is better than gymnas-
tics for the general run of children; and if girls
were allowed by social feelings to play as boys do,
they would cease to be so subject to spinal deformi-
But a certain proportion of children are not suited
by indiscriminate play. They have a tendency to
distortion of the spine, which is easily brought out
by many forms of sport.
Any exclusive use of one side of the body is there-
fore dangerous. Base-ball is a vigorous and useful
sport ; but it is occasionally the cause of lateral dis-
* James J. Putnam, M.D. " Gymnastics for Schools," in the
American Journal of Social Science, No. VIII., 1876.
tortion, owing to the excessive use of the right arm
and hand. Bowling would seem likely to have the
same tendency. Croquet is a very distorting game,
unless both hands are used alternately, or one as much
as the other, to strike the ball.
The position of a woman on horseback is one
which is apt to cause a "corkscrew" twist of the
spine. And the common games of running and
tossing, which do children so much good, are not so
directly adapted to prevent or cure spinal deformity,
or to make a girl full-chested and symmetrical, as is
a course of gymnastic training under the charge of a
Evidently, if we accomplish this greater object of
correcting the weak points in the frame of a child,
we gain at the same time those benefits — improved
appetite, complexion, sleep, mental briskness — for
which adult gymnasts so much prize their art. As
for play, when can the girls in a city boarding-
school, for example, play? Certainly not while on
their daily walk, two by two, in the paved streets.
" To establish a department for physical training
demands but little change in the present school sys-
tem, since almost any school-room may be trans-
formed almost instantly into a gymnasium, no appa-
ratus being required for the lower grades, and only a
few light implements carried in the hands for the
more advanced pupils, and each scholar needing only
40 SCHOOL AND INDUSTRIAL HYGIENE.
space enough upon the floor for a step in each direc-
tion, and room to straighten the arms in front and at
the sides. Of the pupils the requirement is slight,
being merely that the dress shall be short enough to
leave the feet unencumbered, loose enough to admit
of a full inhalation without feeling the clothes at the
waist or across the chest, and large enough to permit
the free play of every muscle in the body. For this
no special costume would be required, except in the
highest grades. Music is a great addition to the ex-
ercise, but not a necessity. But the great difficulty,
and, in fact, the only serious one, is the dearth of reg-
ularly trained teachers of gymnastics, who are not
only fully prepared for the work, but who are enthu-
siastic in the cause, and able to impart their informa-
tion to others. This arises from the low standard of
physical culture admitted by public opinion. Let it
once be required, that those who teach this branch
shall of necessity be regularly trained, and there will
be a supply of good teachers in a marvellously short
"In Sweden, the celebrated system of Ling is an
obligatory study in all public schools, three to six
hours a week being devoted to it, subject to the ad-
vice of a physician, who is appointed to examine each
scholar at the beginning of the school term. For the
* Quoted by Dr. Putnam from a letter received from a teacher
of gymnastics in a "girls, normal-school."
education of teachers there is a great central institute
at Stockholm ; and the graduates from the normal-
schools must moreover have passed a special exami-
nation in this branch. A large part of the instruc-
tion is in the so-called ' free exercises,' including
proper methods of sitting, standing, lying, walking,
running, jumping, as well as exercises in concert,
games, etc. The aim of these free exercises is to
call into action in turn the greater part of the volun-
tary muscles of the body ; and with an intelligent,
earnest teacher to direct them, there is no end to the
modifications and combinations that can be made,
calling for precision and strict attention and skill on
the part of the pupils." [Ibid.']
The city of Frankfort-on-the-Main is an illustra-
tion of what may be done by an enlightened commu-
nity, led by far-seeing hygienic genius. Gymnastic
exercises were first introduced there nearly seventy
years ago ; but the progress has been very slow in-
deed, and it was only a few years ago that the regu-
lar practice of such exercises, under trained teachers,
was made obligatory upon the public-school children
in that city. Most of the twenty-five schools already
possess a "turn-halle," and others are building. The
new halls pre to be from 20 to 25 meters long (66 —
S3 feet), 9 or 10 meters wide, and 5 — 5.6 meters high
(about 17 — 18 feet); they are all well furnished with
42 SCHOOL AND INDUSTRIAL HYGIENE.
apparatus ; that used by girls differs somewhat from
that used by boys.
There were 12,101 children in the public schools
in 1878, of whom 10,844 attended schools where
gymnasiums existed and exercise was obligatory. A
medical certificate of disqualification is required of
those who are excused ; the number wholly excused
amounted to two and a half per cent. The scholars
exercise two hours every week. They are always un-
der the charge of teachers specially qualified for the
work by instruction received in gymnastic normal-
schools, and in classes taught by the inspector of
gymnastics. These teachers are not ignorant men,
nor "pure specialists" of gymnastics; they are all
regularly qualified teachers of the literary branches,
and the hours during which they are engaged in teach-
ing gymnastics are counted in with the twenty-six
required weekly hours, just as so many hours of Latin
or music would be counted. One hundred and four-
teen teachers are thus employed, performing an amount
of duty equivalent to foe. full time of seventeen teachers ;
which may be estimated as costing the city 46,270
marks, or about one dollar for each child. The value
of this exercise to the teachers is as great as to the
It is thought desirable that the number of weekly
hours should be increased. Another recommenda-
tion is made by the authority from whom I quote
this account,* to the effect that the city should pro-
vide public places for children to play in, both for
sanitary and moral reasons — a recommendation which
is as important in America as in Germany.
It is interesting to remark that the youngest chil-
dren use chiefly free-hand exercises ; that the boys
take the fixed apparatus by degrees, and at last use
them chiefly; while the girls, who in the middle
classes use fixed apparatus like the boys, in the upper
classes return, for the most part, to the use of lighter
instruments, suitable for young children.
Public sentiment is not at present favorable to such
thorough-going work in America. To the crowds of
men and women in our large cities who were born in
the country, and remember its free and natural sports,
its days spent in the open air with the beasts, fowls,
and fishes, a course in gymnastics will seem but a
tame thing. Those city men who have been forced
to use a gymnasium for their health, have not gener-
ally a very cheerful impression of the place. In fact,
the actual substitute, in our cities, for that immensely
popular German institution, the Turn-Verein, is the
volunteer militia company, which gratifies the love
of exercise, the social instinct, and the love of rule,
order, and co-operation in a very similar way.
A gymnastic class in a school should consist of the
* G. Danneberg : Das Stadtische Schuitumen zu Frankfurt
44 SCHOOL AND INDUSTRIAL HYGIENE.
scholars in one room, or any suitable fixed number;
their teacher should have precisely equal authority
with their class-teacher (in Amherst College, the
teacher is a Professor and member of the Faculty) ;
and the exercises should be controlled as those of a
soldier are — not with the same stiffness, but with
constant care lest the boys injure themselves by am-
Even in Frankfort, the present complete system
has only been introduced in the most gradual man-
ner. If it is ever made a part of the American sys-
tem, — and I cannot see why it should not ultimately
be, — the same way must be followed. I would sug-
gest, as a stepping-stone, the introduction of a very
thorough gymnastic training in our normal-schools.
In three years, a young woman cannot only much
improve her own constitution, but can become im-
pressed, from experience, with the value of gymnas-
tics. The great difficulty to be overcome is the fact
that few teachers really know what physical exercise
can do for a person ; what elasticity and smoothness
of temper ; what power of continued attention and
work it is capable of imparting.
Girls really need gymnastics more than boys, in
cities, owing to the very great restraint placed on
their freedom, and the improper modes of dressing
which still prevail. One of the readiest ways to per-
suade young women to dress rationally is to make
them feel by contrast the comfort of living in bodily
freedom, as must be done, for the time, at least, by
those who practise gymnastics.
Would it be too great a luxury for a democratic
community to indulge in, if all children were in-
spected by the quick and practiced eye of a medical
expert, once a year, especially during the ages of
rapid growth? and if the results of such examinations
were made known to the teachers of gymnastics for
their guidance? In every hundred children, there
are always some who are tending to special deformity.
It would be very easy, in most cases, to prevent this
by suitable exercises, performed with very cheap ap-
paratus, for a short time, every other day. Other
children are weakly, and should have special exemp-
The adoption of special teachers in gymnastics is
strongly to be urged. It is too much to expect of
the literary instructors that they shall always be
strong enough to perform the severe duties of in-
structing in gymnastics three times a week. Such
duties are much more toilsome for the teacher than
for the pupil. There are plenty of most valuable
instructors who could not bear the additional strain.
But as regards calisthenics of a very light description,
performed daily once or twice, for relaxation more
than for development, the ordinary teacher is per-
46 SCHOOL AND INDUSTRIAL HYGIENE.
fectly competent to perform and teach them. I will
give a specimen of the latter to illustrate :
" Body erect, heels together, feet at angle of 6o°,
chin not protruding, eyes front, hands closed, knuc-
kles touching shoulders as nearly as possible, elbows
touching sides with exactness.
" Right hand down, up, down, up; left hand down,
up, down, up; right down; right up and left down;
right down and left up; right up; both down, up,
down, up (16 movements).
" The same alternation may be applied to forward
movements resembling a boxer's blows, and to lateral
and upward movements. This series is one of the most
elementary, and when learned so that the whole class
does it with prompt uniformity and in good time, —
the music, if possible, of a piano or drum, — a slight-
ly harder series may be undertaken. This course will
bring into use, by degrees, all the chief muscles in
bending and twisting the trunk, limbs, and neck."
Military drill is an excellent thing in general ; it
should, however, be restricted to the stronger boys.
Small and weak fellows are easily injured by carrying
a musket for a long distance. My friend, Dr. Buck-
minster Brown, has mentioned to me one or two
cases in which he believed congestion or inflamma-
tion of the membranes of the spinal cord at the
level of the shoulders to have been thus caused.
In a long session, there should be a pause at the
close of every hour, in which the scholars should be
allowed to go out of doors.
A short session of three hours may require only
one pause, which should, however, be of twenty or
thirty minutes, in the case of children.
Clothing should at all times be easy and allow full
inspiration by chest or abdomen, without any sense
of pressure ; the feeling should be nearly the same as
when no clothes are worn. The so-called "dress
reform" for women effects this by making most of
the weight depend from the shoulders.
One of the chief faults of feminine attire — the
pinching of the waist where the skirts are fastened —
is imitated by boys with a leather strap. It is dan-
gerous to exercise with a tight strap or string around
The feet are often neglected. Children (old enough
to "study philosophy") will come to school in thin,
wet shoes from simple negligence, or because they
have "lost" their rubbers. They should be sent
home by the teacher for dry shoes and stockings.
On very wet days it would not be amiss for the pupils
to bring at least a dry pair of stockings to school
with them. This is especially important for oldei
CARE OF THE EYES.
THERE is no hygienic point where the teacher
can render more distinct service than in rela-
tion to the eyes of his scholars. The functions of
this organ are so dependent for their perfection
upon a thoroughly sound condition of health, that
a complete account of their relations would bring us
in contact with most points of hygiene. But, of all
public servants, the teacher ought to be best informed
of the dangers, and best able to assist the child in
In the valuable little treatise on the " Care of the
Eyes," by Mr. Brudenell Carter, we find these words,
which may be laid to heart :
"It is very worthy of note that, in the experience
of ophthalmic surgeons, it is exceptional to meet with
a child suffering from defective vision who has not,
before the defect was discovered, been repeatedly
and systematically punished by teachers or school-
masters for supposed obstinacy or stupidity. The
very reverse of this practice is what ought to obtain,
CARE OF THE EYES.
and apparent obstinacy or stupidity should lead, from
the first, to the question, 'Can you see perfectly?' "
It may be added that deafness, due to causes easily
removed if taken in time, is often misunderstood in
the same deplorable way. Deafness, however, cannot
be considered a "school disease " in the same sense in
which many diseases of the eye are such. Both the
eye and the ear, however, are peculiarly the instru-
ments of school-education, and a teacher who is ig-
norant of their essential construction and laws knows
not the tools of his trade.
There is one affection which is so common, and so
directly dependent (in many cases) on -,chool-life,
that it may well occupy our first attention. I refer
to short-sight, near-si B ht, or myopia.
A child with normal eyes ought to be able to read
this page, in a good light, at the distance of forty
inches, and at all intervening distances down to four
inches: this is a very moderate test for young eyes.
Any child who cannot read it as far as fifteen inches
off should have his eyes examined by a competent
oculist. No disease is more certain to increase if
neglected, and none is better understood by scientific
experts, and r_.ore susceptible of exact statement and
The near-sighted eye is one which has too great a
diameter from front to rear, so that the retina — which
lies at the rear — is beyond the point at which pencils
50 SCHOOL AND INDUSTRIAL HYGIENE.
of rays from far objects are focalized. This condi-
tion is illustrated by the following diagram from Dr.
Harlan's Health Primer, in this series, on "Eye-
sight, and How to Care for It," in which the whole
lines represent the outline of the normal eye with
the lens, and rays of light from a distant object com-
ing to a focus on the retina; while the dotted lines
represent a near-sighted eye, with rays from a very
near object coming to a focus. In near-sightedness,
rays from distant objects may be represented by the
whole white lines, which are focalized before reach-
ing the retina, giving a diffused image, in which each
point of the object is seen as a larger blurred point
and each line as a wider blurred line.
This defect is irremediable when it exists as an
anatomical fault ; but very much may be done to
prevent its increase when discovered, especially in
children. It must be remembered that some chil-
dren are looked upon as near-sighted because they
have the habit of holding their work too close to
CARE OF THE EYES. 5 1
their eyes. This habit may arise from the very oppo-
site cause, namely, far-sight ; it may originate in
sheer indolence, a faulty desk or seat, or poor light,
and may be continued merely as a habit. And the
degree of near-sight is easily over-estimated by those
not able to apply the scientific tests of the professed
oculi&t ; for in many cases there exists a temporary
exaggeration of near-sight, due to the strain entailed
by the effort to read or see fine objects, which easily
passes away with change of occupation.
In order to prevent, we must first understand some-
thing of the causes of this complaint.
There is a strong tendency for the malformation,
once developed, to be transmitted to children. In
all probability, near-sight begins, in many children,
at a very early age ; but in most cases a great deal
can still be done to prevent its increase.
It is believed that an eye which is predisposed to
near-sight has naturally a more yielding and delicate
envelope, which, under the influence of close appli-
cation to near vision, yields to the compression which
that act necessarily causes (and causes, also, in a
sound eye) ; and as the yielding occurs chiefly at the
rear of the eyeball, that portion is very gradually
pushed back, and the whole globe becomes elongated.
This tendency to yield may exist as the result of
three causes : first, as an inheritance from near-sighted
parents ; second, as a characteristic of weakly, flabby
52 SCHOOL AND INDUSTRIAL HYGIENE.
children, with tissues which do not resist pressure
well ; and, third, as a general characteristic of child-
hood, when all the tissues are soft.
Of prevention, as applied to the first of these causes,
I will not speak ; but the second is at once suggestive
of the great importance of preserving strong and
lusty health for the sake of the eyes ; and as to the
third, it affords a hint that childhood is not, perhaps,
a suitable time for close application with the eyes.
Robust and active children are less likely, on the
whole, to be affected, both because their tastes lead
them into the open air rather than to books, and be-
cause they generally possess a tougher fibre. Any-
thing which depresses vitality is capable of weakening
the power of vision. Bad air in school-rooms is cer-
tainly capable of causing bad eyes ; it provokes the
general condition of listlessness and languid function
which predisposes to near-sight and other diseases of
the eye. Fresh air in the school-room is absolutely
necessary for this reason. Delicate health, dyspepsia,
catarrhal, and other weaknesses may be considered as
aiding the tendency to near-sight. Convalescence
from acute fevers, as measles, is often associated with
a weakness of the eyes which should forbid their use
for a time. Diphtheria not seldom causes a paralysis
of sight, which should be very carefully looked after
both by teacher and doctor, and all use be prohibited
until complete recovery ensues.
CARE OF THE EYES. 53
It is a false and mischievous view that considers
the near-sighted eye a strong eye. Such an eye is
"strong" only in respect to minute objects, while,
for almost all the pleasures and duties of life, it is a
half-blind eye. There is, too, a tendency, happily
seldom realized, to destroy sight by separation of the
retina from the outer coats of the eye — a painless
process, but frightful to contemplate as the possible,
and in fact the logical, termination (so to speak) of
The mechanical pressure exercised in the act of
looking at near objects by the muscles used in fixing
the globe has been mentioned. The distention which
this pressure tends to produce is quickly recovered
from if the eye is rested often ; its effects are exag-
gerated by the excessive fineness of the objects looked
at (as in embroidering, and small maps and type), by
poor light, by fatigue, by sleepiness, by an over-
heated room, or cold feet ; by tight clothing around
the neck, by the effect of a recent hearty meal, or by
protracted use of the eyes ; and, in general, by any-
thing which causes congestion of the eyes. The eyes
are decidedly better able to bear fatigue in the fore-
noon than in the afternoon. The position of the
body is important ; stooping forwards should be pro-
hibited, and the eyes not allowed to approach nearer
than fifteen inches in general to the book or slate.
The proper shape and proportion of a desk which
54 SCHOOL AND INDUSTRIAL HYGIENE.
will facilitate the fulfilment of these requisitions will
be described hereafter, as well as the proper arrange-
ments for lighting a room.
The reader is referred to Dr. Harlan's work in this
series for a fuller account of " How to Care for the
Eyesight ' ' than can be given here. A few remarks,
however, are here quoted :
"It is well in reading to interrupt the strain of
continuous gaze upon the page, and rest the eyes, by
looking into the distance occasionally, even if only
for a few seconds. In studying, or in reading any-
thing that requires thought, this is likely to be done
unconsciously ; the natural condition in close thought
is rest of everything except the brain.
" As distant vision represents rest for the eyes, and
near vision represents exertion, care should be taken,
in reading, not unnecessarily to increase this exertion
by holding the book too close. The book should not
be held nearer to the eyes than is necessary to make
the print appear perfectly sharp and distinct, and no
print should be read continuously that cannot be seen
clearly at about eighteen inches.
" Without any optical or other discoverable reason,
or, perhaps, merely in consequence of a careless and
lounging way of sitting, young people often acquire
the vicious habit of reading with the book held close
to the eyes — a habit which, if examination of the
eyes proves it to be nothing more, should be strictly
CARE OF THE EYES. 55
discouraged. It is very important, however, to de-
termine positively that there is no physical cause for
the habit, and to remember that true short-sight de-
pends upon the form of the eyeball, which no amount
of discipline can alter. Great injustice is often done
to children by accusing them of obstinacy or inat-
tention, when they are the subjects of physical defects
of sight or hearing. Those with a high degree of
long-sight are particularly liable to be misunderstood ;
for, though they can see distant objects better than
near ones, they sometimes hold the book close to the
eyes to make the print appear larger, and thus par-
tially compensate for their dimness of sight. Chil-
dren with astigmatism often appear stupid or inatten-
tive, because there is in this defect what the subjects
of it sometimes aptly call ' slow sight ; ' that is, they
do not recognize a word quickly on first sight, but
' it seems to come to them afterwards.' Astigmatism
is that condition in which all lines running in a given
direction look blurred — as all the upright or all the
" In reading while lying down, it is hardly possible
to hold the book in a favorable position, and the ex-
ternal muscles of the eye are strained. In addition
to this, when the head is on a level with the body,
instead of erect, there is a tendency to an excess of
blood in the eyes.
" It is not well to persist in reading when overcome
56 SCHOOL AND INDUSTRIAL HYGIENE.
with sleep, as there is a constant tendency for the
muscles of accommodation to relax, and of the eyes
to diverge, and they have to be forced back to their
work by an effort of the will. The effect of this is
soon shown in a congestion of the blood-vessels of
the conjunctiva [white of the eye]."
This is the place to speak of the excessively bad
and trying character of the letters on many maps
used in schools. Some most excellent works, as re-
gards thoroughness and execution, are absolutely in-
tolerable on account of the fineness of the engraving.
Other maps, printed from old and worn plates, are
sold, which it would require the microscope of an
expert to decipher. Maps for children ought to con-
tain few data; geography should be largely taught by
wall-maps and outline maps; and long search for
places, too often hidden like " the needle in the hay-
stack," should be discouraged.
Greek letters are not harder to read than a clear
manuscript, if they are well printed. There is an
old Greek type which is very trying, however. Lex-
icons are an indispensable part of a classical educa-
tion, and the utmost care should be given to clearness
The most agreeable tint for paper is either a cream
color, like that of this page, or a pale blue (which is
commonly taken for clear white), produced by adding
a pigment. The practice of calendering the sheets,
CARE OF THE EYES. 57
to give a gloss, is altogether improper, for it causes
them to throw a dazzling reflection in many lights.
It should be remembered that drawing, when the
eyes have frequently to look from the page to a dis-
tant object, may be quite fatiguing. Drawing maps
on a small scale must be forbidden ; no names, for
instance, should be inserted in a smaller handwriting
than that which is usual. A large handwriting for
ordinary purposes should be taught. Fine embroid-
ery and lace-work are notoriously destructive to the
eyes. As an illustration of the effect of too close
work with the eyes, I will mention a recent minute
edition of Dante's Divine Comedy, which occupies
a volume measuring 2 by 1 T 4 D inches. The type is so
minute that it had to be destroyed after use, owing to
the impossibility of distributing it ; and several work-
men had to stop working on it on account of the
injury it caused.
Pale ink and greasy slates are trying to the eyes.
Some other points will be mentioned hereafter.
The connection of near-sight with school-life and
work has received a great deal of attention within
the past twenty years. Statistics were first published
by Cohn, of Breslau, who examined the eyes of
10,060 school-children, and found that of this num-
ber 1004 were near-sighted. Since then many ex-
aminations of smaller numbers of children have been
made in Germany, Russia, Switzerland, and America,
58 SCHOOL AND INDUSTRIAL HYGIENE.
with strikingly similar results. It seems to be a uni-
form fact, that the youngest classes have the fewest
near-sighted children and the oldest the most. In
Konigsberg, the difference was found to be as nearly
six to one. In New York, the difference was nearly
as eight to one.* It may be a matter for congratu-
* Statistics by Drs. E. G. Loving and R. H. Derby, the ages
ranging from 6 to 21 years. Percentages in the lowest classes,
3.50 ; in the highest, 26.78, near-sighted per hundred.
Other American observations give the following results :
Cincinnati, 630 students : District schools, 10; Intermediate,
14; Normal and High, 16, near-sighted persons in 100.
Brooklyn Polytechnic, 300 students : Academic Department,
10 per cent. ; Collegiate Department, 28 per cent.
New York College, 549 students: Introductory class, 29;
Freshman, 40 ; Sophomore, 35 ; Junior, 53 ; Senior, 37 per cent.
Buffalo public schools, 1003 pupils: the percentage of near-
sightedness increased from 5 at seven years of age to 26 at
eighteen years. It was further ascertained that one of every
four graduates of the Buffalo High-School was near-sighted.
Dayton (Ohio) public schools, 765 pupils: near-sighted, 18.96
In Amherst College, as has been shown by the very careful
examination recently made by Dr. Hasket Derby, the percent-
age of normal eyes, on entering, is 50.8 ; on graduating, 36.
The percentage of far-sight on entering is 5 ; on graduating,
13.2; that of near-sight on entering, 44.2 ; on graduating, 50.8.
Amherst students have the reputation of working well at their
books, and they are certainly not a puny or unwholesome set.
They are rather largely country boys. This refers to the class
graduating in 1879.
The statement for the class of 1880 (which I owe to the kind-
CARE OF THE EYES. 59
lation that we have in America fewer actual cases of
near-sight, — perhaps one-half as many as in Germany;
but it would seem that the tendency of near-sight to
increase rapidly as school-life advances is quite as
marked here as there.
It is really a serious question whether the attain-
ment of high culture is necessarily attended by my-
opia in a large percentage of persons. The German
nation is a spectacled nation : it has not lost its mil-
itary qualities nor its intellectual preponderance in
certain directions ; but who likes to think of a uni-
versal use of glasses for ordinary vision by children
and adults alike? And yet, if it were possible to
send the whole nation to school up to the age of
eighteen (in their way), this result would seem likely
to follow. Perhaps among the drilled and orderly
masses of Germany, where the boys (little old men)
never throw stones or steal apples, the disadvantage
ness of Dr. Derby, as it is not published) is to the effect that
near-sight developed from previous normal sight in 7 per cent,
of the whole class increased in amount in t,]/ 2 per cent., and re-
mained unchanged in 22.8 per cent. This is favorable, as com-
pared with other statistics. Perhaps the mere fact of attention
being paid to the subject has increased the care of the students;
doubtless the gymnastic exercises have had a good effect.
These statistics, except the first and last, are quoted from the re-
port of Dr. Conklin, of Dayton, upon the " Effect of School-Life
upon the Eyesight," printed by the School Board, 1880. They
are not very extensive, but ihey should dispel the idea that near-
sightedness will take care of itself in America.
60 SCHOOL AND INDUSTRIAL HYGIENE.
of partial blindness is not so great as it would be
here; yet who wants a near-sighted policeman, or
sailor, or stage-driver, or a spectacled actor or singer?
The effect of near-sight upon the character has not
been studied. We would add, for the thoughtful
consideration of parents, these words from Mr. Car-
ter's book :
"It will be manifest, on reflection, that the mat-
ters which are lost by the short-sighted, as by the
partially deaf, make up a very large proportion of
the pleasures of existence. I am accustomed, on
this ground, strongly to urge upon parents the neces-
sity of correcting myopia in their children ; and I
am sure that a visual horizon limited to ten or even
twenty inches, with no distinct perception of objects
at a greater distance, has a marked tendency to pro-
duce habits of introspection and reverie, and of in-
attention to outward things, which may lay the foun-
dation of grave defects of character."
Homer was, assuredly, the possessor of a good
pair of eyes — at least, in his youth !
If near-sight is at all connected with compulsory
and protracted education, — that is, with the methods
by which modern civilization is supported, — it be-
comes a national question of a grave character,
whether the connection is a necessary one, or whether
means for preventing its growth are not feasible.
These means do exist, and it is our duty to urge
CARE OF THE EYES. 6 1
Children are incapable, for physical reasons, of
enduring long protracted effort. This is true not
only of the mind, but of the eye, and for very
tangible reasons. Their tissues are soft, — bones,
tendons, muscles, and skin alike, — and yield readily
to pressure. Now, no fact is better known than that
near-sightedness is increased by- the yielding of the
fibrous coats of the eye under the pressure of the act
of reading ; and it is equally well known that child-
hood is, par excellence, the period when near-sight-
edness commences. Nature forbids the young child's
brain to be used for a single task more than fifteen
minutes or so ; and to this fact, now understood by
most teachers, should be added that the child's eye
will not bear anything like the continuous strain that
an adult's will bear.
Children differ greatly in this respect, no doubt ;
but the State should not exact tasks which are likely
to injure even a small proportion of the whole.
A school for young children should present a very
different aspect from that offered by an academy.
The eyes should frequently wander. If academic
tasks are given, the evidence of momentary fatigue
and inattention should not be interdicted. If the
school is held in the afternoon, in summer, what can
prevent an occasional nap ? (It may be remarked,
by the way, that no one should read while sleepy, or
just after waking. ) A rational regimen for children
62 SCHOOL AND INDUSTRIAL HYGIENE.
should include vigorous play, or mechanical or agri-
cultural instruction, for a considerable part of the
day, with very limited hours of study. The latter
must be interrupted, for the youngest children every
quarter of an hour, by a change of position, stand-
ing, walking about, and by change of study ; for
older children the intervals may be less frequent; but
until maturity is nearly reached (say until the age of
sixteen), it is best to have a complete break at the end
of every hour for a few minutes at least, with enforced
cessation of eye-work.
If it be proved, as it has been over and over again
in England, Germany, and America, that children
under twelve learn as much in three hours a day as in
five, there would seem to be no excuse whatever for
the cruel custom of confining them for the present
period, with the consequent (we may fairly say the
consequent) inevitable injury to the eyesight of many.
Parents are not to be blamed for desiring that their
children shall gain knowledge rapidly; but it is to be
feared that it will be long before they practically as-
sent to the truth of the proposition, that young chil-
dren become tired after three hours of study, and that
Three hours of good work are better than five hours
of poor work.
Children not infrequently have far-sighted eyes,
which are not fitted for continuous work upon near
objects, and which, of course, cannot be made fit by
CARE OF THE EYES. 63
any effort of the will. This defect is very liable to
be neglected. It often causes headaches, which may
easily be attributed to a difficulty of the brain.
Convergent squinting is very liable to be the result
of neglected far-sight in children. The remedy for
far-sight is very simple indeed, consisting in the use
of convex glasses. It is utterly useless to spend time
on other methods ; either the child must give up
study, and all work requiring the inspection of near
objects, or he must wear glasses constantly for such
When near-sight is considerable, glasses should be
worn "as a part of the eye." If it is very consid-
erable, two pairs must be used — one for far objects,
the other, much weaker, for use in writing and read-
ing. It is certain that any degree of near-sight
which compels the child to stoop to work at ordinary
well-made desks is productive of congestion and
strain in continued study, which is highly prejudicial
to sight ; this injury may be avoided easily, comfort-
ably, and safely by the use of weak glasses.
It is proper to warn teachers of the contagious na-
ture of certain cases of conjunctivitis (inflammation
of the outer covering of the eyeball, ophthalmia),
and of inflammation of the edge of the lids. A
physician is the proper judge of such cases.
All spectacles or eye-glasses should be selected by
an oculist, /'. e., a physician trained to the special
care of the eyes, and never by a mere optician.
SCHOOL-DESKS AND SEATS.
AMONG the prominent causes of deformity of
the spine and of near-sight among scholars, is
the disproportion or otherwise bad construction of
these necessary pieces of furniture.
"To bad positions in writing, drawing, at the
piano, etc., also while standing during recitations
(upon one foot) ; to carrying weights, heavy books,
for example, more on one arm than the other ; to
too much exercise of one arm, while the other is
comparatively idle, can undoubtedly be traced the
majority of these curvatures (z. e., rotato-lateral cur-
vature of the spine). But it is not malposition alone
that causes the trouble. It is likewise due to long
continuance in one position, which at first may be a
good one, but which, if continued for a considerable
length of time, becomes changed, from simple fatigue
of a certain set of muscles, into a bad one. These
relax ; sometimes one muscle or set of muscles gives
way ; sometimes another set. The burden of support
is consequently thrown, to a great extent, upon the
SCHOOL-DESKS AND SEATS. 65
ligaments which bind the vertebrse together. These,
in a young person, are soft ; their elasticity is soon
overcome, and they are stretched. The chain of
bones of which the spine is composed yields. The
muscles and ligaments no longer do their work, and
the superincumbent weight of the head and shoulders
bends the chain, or perhaps the preponderance of
other muscles, not so easily fatigued, disturbs the
equilibrium, and a curve is the result. This curve
may commence in the dorsal region, between the
shoulders, or it may begin in the loins." *
Such a curve is easily straightened at first, but
becomes a "fixed fact" after a while, owing to a
permanent change in shape assumed by the vertebrse
under the influence of continued pressure.
The faults in school-desks and seats which tend to
produce deformity and defects of sight are the fol-
1. Desk too low, causing a forward stoop, with
tendency to congestion of the head and formation or
increase of near-sight.
2. Desk too high, causing undue elevation of one
shoulder, usually the right, with tendency to spinal
* Buckminster Brown, M. D. : " Influence of the Prevailing
Methods of Education on the Production of Deformity in Young
Persons," etc. Lecture delivered before the American Social
Science Association, Department of Health, 1879.
66 SCHOOL AND INDUSTRIAL HYGIENE.
3. Desk too far from the seat, with stoop of the
body, injuring the eyes. Both here and in No. 1
there is danger of injuring the health by compression
of the abdomen and chest ; dyspepsia, small chests,
4. Flat desk-lid, interfering with freedom in writ-
ing, disadvantageous as respects receiving the light,
and compelling the child to hold up his book in order
As to seats, we have :
5. Seat too high, so that the feet are not supported,
and the legs grow weary.
6. Insufficient support for the back, causing fatigue
and improper attitudes, and consequent tendency for
the spine to yield and take a side-curve.
7. Seat not hollowed suitably, causing pain and
8. Well-proportioned desk and seat, not adapted
to the age of the child using them.
In general, discomfort is an indirect cause of
deformity, as it invariably leads a child to take
Let us now consider the construction of good seats
in detail, making allowance for differences of opinion
among authorities. A medical friend of the writer's,
who has long and carefully studied the question, and
has children of his own in school, concludes that
desks ought to be abolished, and arm-chairs substi-
SCHOOL-DESKS AND SEATS. 6?
tuted. This opinion is only an individual one, how-
ever, and we shall assume the necessity of desks.
The desks used for American public schools are
usually fairly good, though there are glaring excep-
tions. The newer models usually give a separate seat
for each child, which is desirable in the interests of
discipline and cleanliness ; and as regards shape and
proportion many are praiseworthy. The chairs are
commonly made comfortable by a slight backward
tilt of the back-piece, and a corresponding upward
tilt of the front of the seat-piece. The scholar can
thus find perfect support in reading when desired.
Liebreich considers that " the back ought to be
straight, and consist of a piece of wood only three
inches broad ; " "not high, and not slanting back-
wards;" "the top to be one inch lower than the
edge of the table for boys, and one inch higher than
the edge of the table for girls."
The national characteristics are shown in this dif-
ference. The American seat is thoroughly easy to
lean back in ; the German seat is suited to keep the
child in an erect, semi-military attitude, with right
angles at the knees and hips ; and, in point of fact,
it does keep him so, by the help of discipline.
What are the requirements of a good seat and
First, it may be said, it is necessary that they
should not tend to produce deformity of the spine.
68 SCHOOL AND INDUSTRIAL HYGIENE.
It should be remembered, however, that a child is
not, or ought not to be, kept sitting very long at a
time — fifty minutes at the most. He does not re-
quire a chair to lean against continuously, but for
occasional support by way of change. To quote an
expression of Professor Henry J. Bigelow's (Harvard),
"Rest against a well-made chair-back at will,- — change
of posture and variety of movement at will, — seem
to me the best prophylactic against curvature."
Whether a perpendicular back or a tilted back is
used is not essential ; either kind, if rightly made,
Second, an upright position in writing is indis-
pensable ; yet it is extremely rarely seen. The seat
must at least not interfere with such a position. The
desk-lid must not project so far as to touch the
stomach ; but that fault is hardly likely to occur.
The German plan of an upright back probably
assists in forming the habit of sitting erect, and is on
this account desirable. It seems to me perfectly
suitable for all children who have not a commencing
curvature of the spine. If the latter condition ex-
ists, or if there is a tendency to it, a slightly inclined
seat is better, as giving more perfect rest or relaxa-
tion. Not that such relaxation should be maintained
throughout the time of study, but it should be per-
mitted at the scholar's will.
The child who is sitting erect, with the knees at
SCHOOL-DESKS AND SEATS. 69
right angles, the back against an upright support, and
the wrists on the table, is well balanced. The posi-
tion 1 is comfortable, not because of the amount of
support given, but because the support is well placed.
It is suited to a well and vigorous person, although it
does not give so much rest to the over-fatigued body
as a tilted seat does.
If the light is bad, children cannot be prevented
Near-sighted children should be placed in the best
light, and, if the defect is marked, should have weak
glasses to read or write with.
If the desk and seat are suitably proportioned, the
former will be only from six to ten and a quarter inches
higher than the latter; and the book will be from
fifteen to eighteen inches distant from the eyes of a
scholar sitting upright. Near-sight is not uncommon
to an extent which makes it uncomfortable or impos-
sible to read at those distances. It is thought by
modern ophthalmologists, in such cases, much safer
to give a pair of weak glasses than to permit a child
to get the habit of stooping forward, which, of itself,
tends to increase near-sight.
The most luxurious position in writing is one in
which the back is well supported, with a lean back-
ward, and the desk-lid comes pretty well forward, in
fact, within three or four inches of the stomach.
Desks have been constructed with this object ; but
JO SCHOOL AND INDUSTRIAL HYGIENE.
scholars will not write leaning back. The posture
may be enjoyed for a time, but it interferes with
other work ; it is interrupted by reaching to dip the
pen, to get books, etc., and the support at the back
is soon abandoned for the more congenial one af-
forded by the elbows resting upon the desk.
It is an excellent thing if the lid of the desk can
be made in two pieces, hinged together, so that the
piece next the scholar can be raised to an angle of
40 or 45 , and form a book-rest.
It seems to me difficult to maintain an absolute
statement regarding the proper shape of seats. The
reader sees that there are good arguments both for
the tilted and the straight seat. There is good au-
thority for saying that the back should be fully
supported in a slightly tilted posture in writing; but,
in view of the necessity in after life of writing in the
erect position, it would seem that the child should at
least be taught to do it so.
The child may take any position he likes, provided
he does not keep it long. The more he varies his pos-
ture from moment to moment the safer he is. But he
does not usually vary it much in writing ; he gets one
or two favorite bad positions, and only varies them in
degree. It is excessively hard to change such habits
when once formed. The primary school is the place
to form the child in this respect. It is, however,
unnatural for a young child to sit long in one posture.
SCHOOL-DESKS AND SEATS. "}\
A primary class must be allowed to write a few min-
utes only at a time ; by frequent breaks a good deal
of writing may be finally performed.
With these precautions, classes of young children
may be drilled in the art of sitting up in a cor-
rect form. In writing, it is safest to sit squarely
facing the desk (for sidelong attitudes engender the
corkscrew, spiral curve of the spine). The upper
part of the trunk must be straight, the head bowed
as little as possible; "the shoulder-blades, both of
the same height, are, together with the upper arm,
freely suspended on the ribs, and in no way support-
ing the body ; both elbows on a level with each other,
and almost perpendicular under the shoulder-joint,
without any support ; only the hands and part of the
fore-arm resting on the table." [Liebreich.] If lean-
ing against the back of a chair in writing, some sup-
port is naturally given to the elbow from behind.
A child who is expected to write more than half an
hour must have a full support for the back, at least as
high as the shoulders.
The same is true of piano-practising. There must
be a back-rest and a foot-rest also ; the latter is easily
supplied by a hassock or foot-stool.
The point where support for the back is most
needed, for work of moderate duration, is the sacrum,
or bone on which the spinal column rests. This bone
is curved, and the support given by the curve at the
72 SCHOOL AND INDUSTRIAL HYGIENE.
back of a saddle is exactly what should be found in a
good seat. For weakly children, a support for the
whole back is also necessary.
For protracted work, also, unusual support may be
said to be necessary. But there should be no pro-
tracted work without breaks.
The seat must be large enough to support the thighs
for nearly their whole length.
A "carved" seat, i. e., with a saucer-like hollow
of elongated shape to sit in, saves much of the pain
which comes from sitting on fiat boards.
Settees are decidedly uncomfortable and unsuitable.
They do not encourage sitting erect, for the backs are
much tilted ; they do not support the bottom of the
body properly, and the whole weight tends to slide for-
ward ; they are not suitably carved, and press directly
on the tuberosities, or bones that are sat upon.
A foot-rest should be provided for several reasons.
The term "distance" is technically used by the
Germans to express the distance between the edge of
the chair and the perpendicular line dropped from
the edge of the desk. Authorities differ, even in
Germany, as to what the distance should be ; but the
most approved opinion seems to be that it should
equal zero (the plumb-line grazing the seat), or a
minus quantity (the line falling on the seat). Lieb-
reich directs that it shall be zero for writing, and five
inches for reading, which is unobjectionable, as his
SCHOOL-DESKS AND SEATS. 73
desk has a hinged lid which turns up, and assumes an
angle of 40 for reading. He remarks that
" If the child has to read a book placed on the
table at too great a distance, it sits on the edge of
the seat, a very unhealthy and fatiguing position. It
rests the body on the two arms, and, if the difference
between the [height of the] desk and seat is too great,
the chest is supported by the projecting shoulders,
instead of the shoulders resting on the thorax. Soon
this position becomes too fatiguing ; the head, bent
forward, becomes too heavy, and must be supported
by one or both hands at the temples, or by the chin
resting upon both arms. Thus every possible modifi-
cation of the two positions immortalized by Raphael,
in the two angels at the feet of the Sixtine Madonna,
is adopted by the children ; but while the angels look
into the far ether, our children stare into a book,
which, in one of these positions, is only two or three
inches from the eye ; and, in the other, sideways from
the head, and therefore at an unequal distance from
the two eyes.
"It is still worse when writing; with desks and
seats of the ordinary form, only one arm rests on the
table — this is generally the right, while the left
hangs so that the elbow approaches the left knee,
and only the tips of the fingers hold the book on the
table. The edge of the book is no longer parallel
with the rim of the table, but slanting, or even per-
74 SCHOOL AND INDUSTRIAL HYGIENE.
pendicular to it. If we observe the position which
the upper part of the body assumes, we find that the
lumbar vertebrae bend forward, those of the chest
towards the left, and those of the neck forward, with
an inclination to the right ; at the same time, the
lower part of the shoulder-blade stands too far off
from the ribs, and is elevated too much towards the
right, and the shoulder-joint is raised and pushed
forward. To be in such a position for several hours
of the day, at a time when the youthful body is
rapidly developing, must naturally produce bad re-
sults." The author then speaks of spinal curvature
as thus caused, and adds that "the period of the
development of spinal curvature and short-sighted-
ness coincides exactly; and they seem to form a
circulus vitiosus, in so far as short-sightedness pro-
duces curvature, and curvature favors short-sighted-
ness ; while evidently the same bad arrangements are
at the foundation of both these anomalies."
The edge of the desk should be of such a height
that, as the child sits upright and lets the arms fall
freely, the elbows are about an inch lower than the
edge. For girls, the desk may be one-half or three-
quarters of an inch higher than this.
It is a very common fault to furnish school-rooms
with desks of only one size. The diversity of height
among children, differing even only by two or three
years, is such that three sizes ought to be kept in
SCHOOL-DESKS AND SEATS.
each class of a "graded school;" and in a school
of mixed ages, a larger number. To satisfy all re-
quirements, eight sizes are needed, as indicated in
the accompanying table, which is quoted from Var-
Varrentrapp's school-desk and seat, as used by the youngest
This is adapted to all ages by changing the seat only. The
dotted lines cf the seat give the position and dimensions which
are suitable for the older scholars, who can dispense with the
foot-rest. The distances^ i (36.4 centimeters) and /; i (5.2 cen-
timeters) remain the same for all children ; the " difference,"
ip, is slightly increased for the older ones.
SCHOOL AND INDUSTRIAL HYGIENE.
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SCHOOL- DESKS AND SEATS. "J J
rentrapp. The table is especially valuable as giving
the correct heights for the chair and the desk-lid,
which are the chief factors (see columns 3, 4, 5).
The edge of the lid overhangs the seat by about two
inches. If the height of the chair is reckoned from
the foot-rest, the latter is supposed to be .directly
under the knees. The chair-seat is, in fact, much
higher than is common in our schools, which en-
courages the habit of keeping the knees at right
A rest may properly be placed under the desk.
The figure represents a desk which raises the scholar
a good deal (without interfering with comfort), the
object of which seems to be to facilitate the master's
inspection of the writing.
To complete this account, it is necessary to describe
the mode recommended by Liebreich.*
1. One and the same size and model of desk
should be used for children and grown-up persons of
2. The adaptation to the height of each child
should be effected by varying the height of the seat
and the foot-board.
3. The edge of the table is always to be perpen-
dicular to that of the seat.
* " School Life in its Influence on Sight ; " a lecture delivered
before the college of preceptors at the House of the Society of
Arts, July 13, 1S72. London, 1872.
78 SCHOOL AND INDUSTRIAL HYGIENE.
4. No seat is to be without a back, and the top of
this is always to be one inch lower than the edge of
the table for boys, and one inch higher than the edge
of the table for girls.
5. In all classes where the boys change places, the
height of the seat is to be regulated in proportion to
the average height of the pupils.
6. In all girls' schools, in all those boys' schools
where the children do not change places, in boarding-
schools, and in private school-rooms, the seat of each
child should be accurately regulated in proportion to
its height. This is effected by a chair, the seat of
which can be raised and lowered by means of a screw,
while at the same time the back is brought forward
The present writer would say that it seems to him
very desirable to select seats that suit individuals, and
allow them to retain such seats, instead of shifting at
the monthly or weekly change of rank. There is
also, in some cases, much advantage in placing the
near-sighted, the partially deaf, or the unruly near
A MODEL SCHOOL-ROOM.
UNDER this heading, I wish to state a number of
points which have various bearings on the health
of scholars and teachers in an ordinary class-room.
Shape. — For reasons which will appear, a parallel-
ogram is desirable, with the teacher's platform and
desk at one end. This form is better for acoustic
reasons than a square ; and it gives the teacher better
command over the pupils than if the desk is in the
middle of one long side.
Length. — The limit of distance at which large,
clear writing on the blackboard is easily seen (with
letters 2? inches in height) is about thirty feet. There
should be a space between the rear row of desks and
the wall, which may add two or three feet. The
length of the room should, however, in no case ex-
ceed forty feet (Erismann), and is limited by Var-
rentrapp, Zwez, and others, to nine or ten meters (30
to 35 feet).
Width. — This is restricted by the fact that all the
windows are supposed to be placed on one of the
80 SCHOOL AND INDUSTRIAL HYGIENE.
long sides of the room ; and that these windows will
not light up a room effectively if its depth exceeds a
certain ratio to the height of the window. This ratio
is commonly set as 3 to 2 ; so that if a window-head
is fourteen feet above the floor (which is rarely the
case), the light will penetrate effectively to a distance
of twenty-one feet. Again, allow three feet for the
width of the passage beyond the farthest desk, and
twenty-four feet is seen to be the extreme allowable
width; or, if the window is 13J feet high, about
Height. — This is limited to thirteen or fourteen
feet, by practical considerations, such as the expense
of building and heating.
Windows. — The direction from which light comes
to the desk of a scholar is of great importance. It
is universally agreed that for general purposes that
which comes from the left is best. Almost all au-
thorities of scientific weight order that this be made
the rule, and, in fact, the Germans generally forbid
the use of windows upon any other side of the room.
It may be said that light from the right hand is as
useful to read by as that from the left. This is true ;
but in writing, such a light is very annoying. And
a combination of lights from the right and left throws
a double set of shadows, which is also trying to the
eyes. The same may be said of a combination of
light from the left and rear.
The worst light, in general, is that from directly
A MODEL SCHOOL-ROOM. 81
in front of the scholar. It pains the eye, if intense.
If moderate in amount, it still inflicts an unconscious
strain on the retina, by throwing on it an illumination
which would be healthful if the eye were not at work
on small objects, but which is a needless tax on the
endurance of the laboring organ. Practically, any
one may prove that it is much harder to read with
the book held towards a window than with the book
held away. This difficulty is felt by the scholar, who
tries to remedy it in his own way.
Sometimes he holds the book closer to his eyes,
which aids in developing near-sightedness. Some-
times he twists his body around so as to receive
the light on his book in the natural way, and this,
if allowed, may contribute to " one-sidedness " or
crookedness of figure.
Windows in the rear, fronting the teacher, are very
annoying to the teacher, and considerably lessen the
power of watching the scholars ; while for the scholars
they are exceedingly bad, as they throw the shadow
of the person on the desk or book.
The most agreeable light to write by is one which
comes from a pretty high point, and strikes the page
at a wide angle. An ordinary window will not give
such a light, but may still be found very suitable if
placed on the left of the scholars.
.Light entering horizontally has hardly any value
for a student who has to use a flat desk. The ex-
82 SCHOOL AND INDUSTRIAL HYGIENE.
periment may easily be made by any one. Hence,
the lower panes of windows are of little use as admit-
ting light for study. The upper parts are by far the
most important, because they throw light to the op-
posite side of the room, and also light up the ceiling,
which in reality is a principal source of light. By
the use of iron beams, the window-heads may be
brought within a few inches of the ceiling.
The reader will easily see the objections to a semi-
circular arrangement of the seats in a room (as is often
the case in primary schools). It is not an advantage
to the teacher to have to turn her head to the right and
the left, as must be done if her chair is near the imagin-
ary centre. Nor can such a group of seats be fairly
lighted without throwing light directly in the faces
of some of the scholars, not to speak of the teacher.
The size of the windows, taken collectively, should
equal at least one-sixth of the floor-space, and ought
generally to be more. In the best American schools,
it is very much more.
Shades. — The best protection against a hot sun is
furnished by Italian canvas screens. Common cloth
shades, with rollers, are good ; they had better be
rolled at the bottom. Shades with slats are better.
White daylight, the unaltered light of white clouds,
or the clear sky is better than colored light to work
by; hence, there is no advantage in tinting the ceil-
ing, or in giving it any other than a clear-white color.
But the walls at which the inmates of the room must
A MODEL SCHOOL-ROOM. 83
be frequently looking, and which cast side-lights into
the eyes at most times, may be tinted of a bluish, or
semi-violet, or neutral hue.
The blackboards should be so placed as to receive
a good light. If put between windows, this is not
the case, and the eye is fatigued bythe bright light
at the side.
Polished, brilliant, dazzling surfaces, or light-col-
ored surfaces on which the sun is shining, should
never catch the eye while at work. The floor should
be dark and without polish. The sun's rays should
never fall on the scholar's work.
Artificial light has to be used in some cases. It
should be given by powerful burners at a considerable
distance from the pupils. Ground-glass is bad for
shades. Ground or ribbed glass is bad for windows.
Gas-light is a very good illuminator when the gas
is good. But there is a great deal of an injurious
substance given off in burning, chiefly consisting of
sulphurous acid, which ought always to be got rid of
by a special ventilating-cap and flue applied to the
gas-flame, so arranged as to lead the spoiled air
straight to the house-chimney before it can mingle with
the air of the room. The tube may be so managed
as to have a powerful ventilating action on the at-
mosphere of the room, also.
Decoration. — The sun is the best decorator, and
should be let in when this is consistent with other
points. Flowers, plants, colored prints, light and
84 SCHOOL AND INDUSTRIAL HYGIENE.
pretty wood for desks, give an impression of great
cheerfulness, which it is very desirable to maintain
in the interests of health. The lower part of the
wall may be wainscoted, to preserve it and facilitate
cleaning. Wall-paper should not be used ; the walls
should be finished with a material that can be cleaned
or else whitewashed.
Architectural ornament is the last thing to be
thought of in a school-house, which should be built,
first and foremost, to do its work well — as we build
a locomotive-engine. "Architecture," i. e., con-
siderations of external appearance, may be considered
a foe to the health of school-children when it is
allowed to absorb school-funds to the neglect of
essential internal parts. The use of flanking projec-
tions, buttresses, pointed arches, or other features
which cut off portions of light, is to be condemned
entirely; the exterior appearance of a school-house
must necessarily be rather plain in certain respects.
Closets. — The children's outer clothing and um-
brellas should not be kept in the class-room, to pollute
the air with their steaming exhalations. A closet
must be provided with space enough for each child's
clothing to hang free of the next one's; and the
closet should be warmed, lighted, and ventilated.
Its position will naturally be near the class-rooin in
The floor should be of hard, close-grained wood,
of a kind which will not easily splinter.
VENTILATION AND HEATING.
IT is impossible to do justice to either of these
subjects separately. The air breathed must be
warmed for a large part of the year. The warmed
air must be got rid of by ventilating apparatus, which,
again, is often in close relation with that for heating.
The annual bills for heating and for ventilation de-
pend equally on the price of coal. In practice it is
found that, unless planned to work together, the
"system" of ventilation often contradicts the "sys-
tem" of heating, and vice versa. Need we speak of
careless masons, carpenters, and tinsmiths, who ren-
der the best plans of the sanitary engineer void and
of none effect ?
In a word : All heating apparatus, with trifling ex-
ceptions, ought to be apparatus for supplying fresh
air. It is impossible to consider the problem of in-
troducing air without considering that of discharging
it. It is absurd to hire one man to get the air into a
room, and another to get it out. And yet this is
practically done in assigning contracts.
8 ' 85
86 SCHOOL AND INDUSTRIAL HYGIENE.
It is not necessary that the same party should do
all the work, but that the different parties should be
controlled by one authority.
Quality of the Air. — It is well to have the inlet of
the air-duct for a furnace protected from the more
violent winds. It is very desirable to place it at
a sufficient height (say ten or twelve feet) from the
ground, in order to avoid low-lying strata of polluted
air. The neighborhood of privies is certainly not a
desirable one ; yet even this circumstance may exist,
as was recently the case in a school in one of the
large northern cities, with most disagreeable results.
The furnace ought not to leak gas. As a rule, the
draught is constantly inward towards the fire and
smoke, so that, even if there are small cracks in the
furnace or flue, there is no discharge of gas. It is
unsafe to have a valve in the flue above the furnace.
Some valves are expressly made so as to shut only
half-way, or to leave half of the flue always open ;
but it is better to regulate the draught, if necessary,
by dampers to the inlet of air under the fire-pot.
A large furnace is best, — one large enough never
to need to be made red-hot. Slow combustion is
economical; but, much more than that, it seems to
supply an air which has not been "killed" or
"burnt." A little very hot air is known by expe-
rience to be distressing, when a large supply of air
heated only to about 90 is perfectly pleasant. The
VENTILATION AND HEATING. 87
discomfort is due to the want of fresh air ; partly,
also, it may be, to a chemical action of the red-hot
iron on the air, or the transit of carbonic oxide.
The addition of a liberal amount of water by
evaporation, in dry, cold weather, is a necessity. At
least, some people are very unpleasantly affected by
air that is not so treated. Nevertheless, there are
hospital-wards (as in the City Hospital at Boston)
heated by the simple introduction of abundant sup-
plies of fresh air that is simply warmed, and not made
moist ; and the result seems eminently satisfactory.
" Indirect radiation " is a term used for those cases
where air is heated at a central point and conveyed
in pipes to the rooms. "Direct radiation" is the
use of radiators in the rooms ; it generally implies
the absence of means for introducing fresh air, and
as such is objectionable, unless for heating entries or
very exposed points.
Apparatus for heating by steam or by hot water are
generally to be praised. The great point to attend
to is, that the air be not heated in excess.
Stoves have several objectionable pofnts. In the
first place, they overheat a part of the room, and
leave other parts cold. This is obviated in a degree
by a screen. But a still more important objection to
most stoves is the want of a method for introducing
fresh air. Almost any ordinary stove can be altered,
however, at moderate expense, so as to give a large
88 SCHOOL AND INDUSTRIAL HYGIENE.
supply of fresh warmed air. The "fire on the
hearth" is an example of the way it is done. A
cylindrical metal screen may be placed around the
stove ; it should reach to the floor, and rise as high
as the stove. Under the floor a pipe is to be led
from the space enclosed by this screen to the outer
air; the pipe passes through the house-wall, and may
have a valve at any convenient place. This converts
the stove into what is commonly called (when placed
in a cellar) a "portable furnace" with "hot-air
box." The fresh air enters the room over the top of
the screen. This plan removes the objections which
attach to air-tight stoves.
Further use may be made of the stove-funnel by
causing it to warm another tube which serves for ven-
tilation only. Thus, the smoke- funnel may be en-
closed in a larger pipe, which is not closed either
above or below, but, starting at a proper point in the
room, rises with the funnel through the roof, and
discharges its own quantum of impure air sucked
from the room.
If the chimney-place is bricked up, a hole may be
knocked in the brick-work, or at a higher point in
A fire in a fireplace in an ordinary city house
may be supposed to exhaust enough air from a room
to make it wholesome for ten persons. If several
gas-jets are burning, this is no longer true; for a gas-
jet of the ordinary kind spoils as much air as two or
HEATING AND VENTILATION. 89
three persons. Of course, an open fire is but a par-
tial means of ventilation for a large school-room,
besides being very wasteful of fuel.
The requirements for good ventilation in a school
are, that the air shall be furnished in a fresh volume
of from 40 to 100 cubic meters (1400 to 3500 cubic
feet) hourly to each scholar. If the room is spacious,
there may be 300 cubic feet of space per scholar, so
that the whole air-contents of the room are required
to be evacuated from five to twelve times an hour !
while, if the room is of moderate size, say 200 cubic
feet per head, the change must go on faster — the en-
tire contents must be changed once every %\ minutes !
And this can be done, and is done, without causing
a draught. But we can see at once, that if the room
is crowded, and the air is wholly changed once in /our
minutes to correspond, the draught will be great. A
closely-packed room is not well ventilated for just
this reason; the inmates cannot bear the draught. A
certain amount of "elbow-room " must be given, or
the air-currents will not be borne. There should be,
therefore, about fifteen square feet of floor-space for
each inmate of the room, or from fifteen to twenty.
These considerations lead directly to a fact which,
though it stares us in the face, is seldom fully compre-
hended ; that fact is, the expensiveness of ventilation.
Every house requires a considerable amount of heat
to keep its walls warm. Let the house and contained
90 SCHOOL AND INDUSTRIAL HYGIENE.
air be raised to 70 , and let the supply of heat from
the furnace be cut off, the whole amount will pass
away through the walls in a day or two. This is
a necessary waste ; or at least it can only be dimin-
ished by furring and thickening the walls and by
doubling the windows. But to extract every eight
minutes a school-houseful of freshly heated air, and
send it up over the ridge-pole, would seem extreme
folly to any one unacquainted with the facts and the
necessities of the case. This is not the place to ex-
plain these necessities ; suffice it to say that the school-
house is a peculiar place, a very closely packed place,
and subject to those peculiar morbid influences which
attend the close packing of human beings, and which
are so distinctly proved to exist, that the death-rates
of different cities are high or low in proportion to
the number of people dwelling on the square acre.
Fortunately, we have it in our power, by the judicious
arrangement of flues and the liberal use of coal, to
render these school-rooms as wholesome as the aver-
age dwelling-house. I do not say that this is gen-
erally accomplished, for it is not, even in enlightened
In a large school, with a thousand or more pupils
(though it is certainly undesirable to have even as
many as a thousand), a system of flues leading to a
heated chimney is often used to carry off bad air. If
the draught in this chimney could be maintained by
HEATING AND VENTILATION. 9 1
a little steam-engine and fan, an economy in fuel
could doubtless by made, and the experiment should
be tried in some school where there are already steam-
The janitor, under proper oversight, may be made
to feel the importance of his duties, and the impro-
priety of those customary negligences by which he
saves himself trouble and lessens the amount of coal
burned. If lie be found incapable of taking a proper
pride in his duty, he should be replaced by another.
One point is seldom conceded by this class of men.
The cellar air is their native element, and they sel-
dom realize that it is an impure element. They do
not practically know that cellar air is generally un-
suitable for the supply of the furnace air-box. If
not prevented, they will at times close the outer orifice
of the duct, and open a slide which admits the cellar
air into the furnace box. It can rarely be safe to do
There are certain contrivances for letting fresh air
enter a room unwarmed without striking the scholars.
One of the best and simplest is to place a narrow
piece of wood under the lower sash. The effect is to
leave a narrow opening between the sashes, which
admits air in an upward direction.
Another plan is to use a wider board, and pierce it
with one or two wide pipes bent at right angles and
provided with valves ; this, also, throws the wind
92 SCHOOL AND INDUSTRIAL HYGIENE.
upward. This is called the "Maine" ventilator.
Sometimes it is modified by covering the inlet with
tin, perforated with fine holes. The object of doing
this is to prevent the inflow of a great volume of air
in the form of a draught ; but it really shuts out about
three-quarters of the air. Then there is a contrivance
for letting air enter through a sifter of cloth, in the
upward direction ; but the cloth can easily be per-
ceived to lessen the ventilating effect most essentially.
A better method for sifting the air (because simpler
and cheaper) consists in simply tacking very thin
flannel to a mosquito-frame, in the place of gauze,
and inserting the frame as is usually done. If it is
thought desirable, both sides of the frame may be
thus covered. The plan is found effectual.
Dr. Keen, the editor of this series, " tacks or pins
a piece of cloth or newspaper across the lower ten or
twelve inches of the window-frame and to the win-
dow-sill ; then raises the lower sash one inch to six
inches, according to the weather. By this means,
the draught is made to pass in the upward direction,
both from between the two sashes and from the open-
ing beneath the lower sash." *
These inlets for fresh air, however, will not always
let air pass. On a "close day," when there is no
wind, even wide-open windows will, not sufficiently
ventilate a room full of people. If windows are
* See " Winter and its Dangers," Health Primer in this series,
by Dr. Osgood, in which these various plans are illustrated.
HEATING AND VENTILATION. 93
placed on two sides of a room, ventilation is much
more likely to do good ; if on opposite sides, all the
better ; but in school-rooms there is an objection to
this plan, owing to the interference of the light. The
true value of these window arrangements seems to me
to depend on the existence of a chimney or other
similar draught-compeller in the room. If air is
sucked out by the flue, air will readily enter by even
small openings in windows; but if not, a window
opened a foot or two will often have but little effect.
Temperature. — It maybe proper here to call atten-
tion to the disturbing effect which excessive heat has
on the circulation in the brain, especially when the
air at the floor is cold and the air at the level of the
head is hot. A temperature of sixty-five is agreeable
to healthy children, if they have an occasional chance
to stir themselves, and if their clothes are dry. Sev-
enty should not be exceeded ; and it is desirable that
no two parts of the room should differ more than two
degrees (2° Fah.).
Wet clothing must not be allowed to remain on the
scholar's person. This must be an imperative rule,
enforced by the teacher's personal attention.
It is hardly necessary to mention colds in the
throat, head, and lungs as favored by such neglect.
It is, however, easily forgotten that catarrhal affec-
tions of the eye and ear, producing impaired sight
and hearing, and menstrual irregularity, are also
liable to be caused or aggravated by such neglect.
SITE, DRAINAGE, ETC.
SITE OF HOUSE.— This should be as healthy as
possible. The character of the sub-soil should
be known, in order that proper precautions may be
taken against dampness, if clay, hard-pan, or rock
forms an obstacle to natural drainage.
Some protection from the north winds is desirable ;
but the bottom of a valley, or low-lying ground, is
The plan should be such that the sun may enter
every room of the house in the winter as well as
The lot ought to include play-grounds in the city;
at the least, there should be space enough about the
house to allow sufficient light to enter the windows.
This requires a considerable outlay for land, which
seems to be regarded as superfluous in some large
cities. In the recent competition between plans for
model schools, at New York, this point was forced
upon the notice of the committee of award. In their
report, they claim that a public school building in a
SITE, DRAINAGE, ETC. 95
large and densely populated city should not occupy
more than half the lot ; and that, further, " at least
two adjoining sides of the building should be freely
exposed to light and air ; for which purpose they
should be not less than sixty feet distant from any
The terms of competition in this case were, that
the house should accommodate eight hundred chil-
dren, and should be built on a lot one hundred feet
square, facing north, enclosed by buildings of average
city height on the other three sides. As a result of
the competition, it appears to the committee that
such a house cannot probably be built on such a lot
consistently with the requirements of health. The
children can be provided for, but the light will prob-
ably be defective in many rooms even with the best
Height of House. — One of the points to be aimed
at in the sanitary reform of schools is a reduction in
the height of buildings. A strict system of drill
may prove the surest precaution against accident in
case of fire, and deserves to be kept up. But there
are many children — particularly girls — who ought not
to be required to ascend many stairs. In the course
of a forenoon, several lessons may have to be recited
in different parts of the house, with going up and
down ; and the recess or recesses are, or ought to be,
taken in the school-yard. Decided injury from exer-
96 SCHOOL AND INDUSTRIAL HYGIENE.
tion of this sort occurs in occasional cases ; and it is
a disadvantage to any girl to be placed so high that
she is unwilling to take the trouble to go out of doors
Sewerage. — It is doubtful whether privy accommo-
dations, or water-closets, for a large school, can safely
be placed in the cellar. There will pretty surely be
a nuisance of greater or less extent, which is much
more serious than if it existed on an upper story, or
in a yard, since the air of cellars must rise more or
less into the house. If the plan be tried, let all pre-
cautions be taken : if water-closets are used, they
should not be of the pan variety, but rather hopper-
closets, or some form made entirely of earthenware,
and should provide a rapid, abundant discharge of
water; if urinals, they should contain no wood-work
in any place which can be reached by spattering, and
should be made of impervious stone or glass— not
metal. A long trough of masonry, kept partly full
of water, is a good substitute for water- closets. Some
closets should be placed on the different stories, in
any case. It is far the best if the whole can be put
in a tower, semi-detached and accessible from every
story of the main building.
A correspondent from a distant city writes as fol-
lows : " From considerable observation and inspec-
tion of the public schools, I am sure that the water-
closets, on the boys' side at least, are as filthy as they
SITE, DRAINAGE, ETC. 97
can be ; so filthy, in fact, that no decent boy can or
will use them." This state of things is familiar to
me as a reminiscence of childhood ; at present my
observation, confined to the city of Boston, points to
a very great improvement, seconded in many cases
by the very anxious care of the masters. But in
many cases there is a truly shocking state of things,
descending in one case, reported by a correspondent,
to the use of a common waterless privy in the second
story of a school, while in country places there are
numberless cases of shameful neglect. The old-fash-
ioned plan, which allowed all the excrement to lie in
a heap on the surface of the soil, is by no means the
worst of all these. Where earth is plenty and waste
land near by, there is no excuse for not "sanitating"
the privy by throwing in a layer of fresh dry loam once
in a week or two so as to cover up everything, and
removing all the contents together, and burying them,
every two or three weeks at longest. This plan, if
faithfully pursued, will almost entirely destroy odor.
A FEW points may be added of special application
to boarding-schools and private day-schools.
Both classes of schools are very often held in com-
mon dwelling-houses, very slightly changed by adding
an L, or something of the sort.
Dwelling-rooms and parlors are very often not pro-
vided with windows sufficient to light them well for
school purposes. They are, unfortunately, often not
provided with fireplaces — an unpardonable fault.
As regards light, much may be done to improve
matters by using light colors for walls ; by whitening
the ceiling; by cutting down trees in front, and re-
moving drapery-curtains within.
A room with ten or a dozen pupils may be made
comfortable (as regards the freshness of the air) by
an open fireplace. For a larger number there are
needed special arrangements for ventilation, such as
openings in the flues at ten feet from the floor and at
the floor; or tin tubes, heated by one or two gas-
jets, acting as flues.
PRIVATE SCHOOLS. 99
It is, of course, desirable not to let more than two
pupils sleep in one ordinary room. A great deal of
crowding, however, of a very reprehensible sort, may
be found in boarding-schools. Under ordinary cir-
cumstances, 1000 cubic feet of space should be allowed
for one person to sleep in.
The purity of the air depends on many external
circumstances. A house with many windows, on a
corner lot, with free exposure to wind and sun, and
not very solidly finished in the wood-work, is likely
to have much more and better air than one in a nar-
row street, with the rear built around. Old houses
are often musty ; I will not say incurably so, but their
atmosphere is commonly tolerated rather than that
trouble should be taken.
Dormitories should be strictly supervised. A
teacher should regulate, or oversee, the admission of
air by windows at night. A good dormitory for boys
may be made of a long room, with a row of small
compartments on each side, each containing a bed
and a window ; the partitions, not permanent but
screens, not exceeding six feet in height, and the
doors consisting of curtains. Ventilation by open
windows at the ends may be safely practised in the
case of healthy young folks.
Supervision should be exercised, also, in the inter-
ests of morality. Licentious practices are certain to
be introduced, unless this is done. A late distin-
IOO SCHOOL AND INDUSTRIAL HYGIENE-
guished hygienist assured me, that in a boarding-
school which he attended, he was sure that all the
boys but one or two were guilty of such practices ;
and he added that this was not an exceptional
school. But a very great deal can be done, by mas-
ters who are themselves of pure lives, in checking
such tendencies. Teachers, and especially parents,
can do incalculable good by suitable explanations to
pupils of say twelve years and upwards, who sin far
oftener from ignorance than from vice.
Perhaps less needs to be said in regard to girls ;
but it is well known that vicious persons occasionally
enter the best establishments, and that the love of
imitation misleads even those whose behavior and
general intentions are good.
It may be superfluous to say that girls at a board-
ing-school need that kind of care which mothers
should give. It may be safe to let steady young
women of sixteen or upwards go to large colleges for
girls ; but younger girls, in my opinion, ought not to
be placed in large schools away from home. The
tranquillity, the absence of exciting influences, or at
least their absence during a greater part of the day,
which prevail in a well-ordered house, are necessary
at that age, if ever, in laying the foundations of a
firm and steady nervous system. The constant
presence of scores or hundreds of other girls, some
critical, some vindictive, some too demonstratively
PRIVATE SCHOOLS. IOI
friendly, is a strain upon the nervous system of s
Children ought to have some hours in the day in
which to do exactly what they like, inventing their
own amusement, and laughing as loud as they will.
Boys should have a good gymnasium, and, in
the country, place and means for out-door games.
Girls should be obliged to have proper shoes (heels
not over half an inch high), and should be let out (or
led out, if necessary,) to walk twice a day; they
ought to learn the habit of walking while at school.
Music is a fatiguing occupation ; if the scholar is
fond of it, it is not less an exertion, and should not
be carried far (say not over an hour a day of prac-
tice) without a corresponding reduction of study.
And no prolonged practice should be allowed without
suitable breaks, in accordance with general principles
which have been fully explained.
IT may be questioned whether college students should
be included in a work on "school " hygiene. They
are, however, very largely under age and in the grow-
ing period. The average age at entrance in the best
colleges is about nineteen. In the Amherst statistics
it appears that during the four college years they
grow in height 1.3 inches and in weight 11.1 pounds.
The two lower classes, at least, are of the age which
breaks down in military life. They are unformed,
unconsolidated, and none know better than the au-
thorities of colleges how ductile their minds are in
certain directions not laid down in the curriculum of
The inference from these remarks is plain : the
students must not be left to themselves in physical
matters. The younger classes, at least, should be
compelled to attend regular exercises in gymnastics
under the charge of some respected person. The
title and position of professor may confer that re-
spect, or distinction as an athlete and an ingenious
inventor of apparatus may give it ; but a mere prize-
fighter or trapezist is not likely to do well. He should
be chosen with the same care as a professor in Chinese.
The exercises required of a whole class must, nec-
essarily, be such as fall far within the capacity of
some. They should include a brisk run, free-hand
exercises, and exercise with wooden dumb-bells or
light clubs. The class is divided into sections, each
under the lead of a student. There is no reason why
a hundred or more should not exercise at once in
this way, with the assistance of music. Thirty or
forty minutes a day is sufficient for the purposes of
health for most students. Those whose larger mus-
cular development craves more work should be put
into special classes or allowed to use all kinds of
apparatus, but always under the general control of
the teacher. There will be students who could be
trusted with instructing classes, but most of them
have a propensity to lame themselves, and get dis-
couraged over the hardest apparatus the moment they
first enter the gymnasium ; and, in short, nine-tenths
of them are no more fit to be trusted alone than little
boys are with firearms.
The use of the gymnasium is a necessity for those
who intend to do boating. The latter exercise, as
performed in swift shells, has very little tendency to
develop the chest. It brings a great and sudden
strain on the heart and lungs, which is very likely to
104 SCHOOL AND INDUSTRIAL HYGIENE.
be injurious in either of two cases: first, if the boy's
frame is below a certain minimum of development ;
and, second, if, being of fair natural growth, he is
not specially trained to chest -power — the capacity of
the lungs and heart to receive a double amount of
air and blood in a given time. The pulse of oars-
men after a race beats at twice the normal rate, and
a long and careful training alone can make such a
strain safe. If boating is to be encouraged, — and I
believe it should be, — a gymnasium is a necessity.
It is a great benefit to the students to have good,
substantial "commons" provided for them. This is
done at Harvard in a very satisfactory manner and at
exceedingly cheap rates. Many students injure their
health by "boarding themselves" in their own rooms,
and this class especially need such a public provision.
In regard to the structure of college dormitories,
it would be well to place them running north and
south, so that the sun shall enter every window. For
further remarks on the site of buildings, see Chap-
The public have been recently excited at the fatal
epidemic in Princeton College. There is nothing at
all new in such an event; and if instructive, it is so
only in one point, namely, that filth generates disease
in seminaries of learning as readily as in New York
IF a person residing in a school is attacked by small-
pox, varioloid, scarlet-fever, measles, diphtheria,
or any contagious disease of the eye or skin, such
person should at once be removed or absolutely
isolated. It should be left to the judgment of the
physician to decide whether such isolation shall be
considered sufficient to permit the other scholars to
remain. Such may be thought the case if the school
is in the country and has a separate building for an
hospital. It may be thought safe for day-scholars to
come (e. g., to the rooms in the lowest story, while
the patient is in the top of the house) ; but, in gen-
eral, prudence will lead to a suspension.
After recovery, thorough disinfection of the room
used by the patient is accomplished by burning two
pounds of sulphur. Previous to doing this, all bed-
ding is exposed as much as possible by spreading it
on chairs, etc. ; and the windows and doors are
closed tightly. The wood-work in the room, of all
sorts, is then to be sponged repeatedly with solutions
of chlorinated soda or carbolic acid.
106 SCHOOL AND INDUSTRIAL HYGIENE.
In the case of public schools, the following rules
are suggested : *
"A certificate of vaccination to be required of every
child entering the public schools.
"Physicians to be required, under penalties, to re-
port to local boards of health all cases of dangerous
infectious diseases observed by them ; the board to
inform principals of schools.
" The existence of any case of such diseases in a
house to exclude the inmates from attendance at
schools for a sufficient length of time, the propriety
of re-admission being certified to by a competent
"Disinfection of premises and clothing by the
board of health in every house where the above dis-
eases have prevailed.
"Medical authority to be designated, for the purpose
of advising teachers and pupils, and pointing out to
the school committee matters in regard to which their
authority might be used to improve the sanitary con-
dition of schools."
* See " Massachusetts State Board of Health Report," 1878,
INJURIOUS EFFECTS OF INHALING DUSTY AND
IN the present brief sketch an attempt will be made
to present some of the principal injuries which are
inflicted on workmen in various trades by the noxious
character of their work. Some remarks will also be
made upon the number of hours of labor in occupa-
tions which are not of themselves especially un-
healthy; upon accidents from machinery; and, in
conclusion, upon the "expectation of life" in differ-
The present chapter has to deal with a large num-
ber of trades, and many striking facts.
Among those which have excited most sympathy —
and which in truth are adapted to do so — are those
relating to the deadly effects of certain kinds of dust
upon the lungs. The form of consumption which is
108 SCHOOL AND INDUSTRIAL HYGIENE.
thus produced is apt to begin gradually ; though in
some trades the artisan is affected in a few days. It
is not exactly what is known as tuberculous consump-
tion, for it is said that it is not hereditary, and that
workmen who are suffering in its early stages are pretty
sure to recover if they change their employment for
a healthful one. There are a great many kinds of
dust inhaled, and the effects are not all alike in the
different trades ; but, in general, there is a certain
set of symptoms.
In "grinders' asthma," for example, there is first
an irritant, hacking, dry cough, with a scanty expec-
toration of whitish, stringy mucus, from simple irri-
tation of the interior of the lungs. This trouble in-
creases in time, and the man becomes weaker, loses
his breath easily, and breathes with less vigor; he
perhaps begins to spit a little blood. If he leaves
his dangerous trade at this point, he will probably
recover ; if not, he passes into a third stage, where
the tissue of the lungs breaks down in spots and is
expectorated, leaving cavities ; he then suffers from
the usual symptoms of consumption, viz. : hectic
fever, night sweats, loss of sleep, emaciation, and
great difficulty of breathing.
The effect of certain occupations in producing
consumption may be estimated by the statement that,
while among butchers, tanners, glovers, coopers, and
brewers only from 7.9 to 11.2 in 100 have consump-
INJURIOUS INHALATION. IO9
tion, brush-makers have 49. 1, file-cutters 62.2, needle-
polishers 69.6, and flint-workers 80, in 100. These
figures represent European experience, and are taken
from a large number of workmen of all classes enter-
ing a large public hospital in Berlin. Expressed in
words, they'signify that while consumption is, unfor-
tunately, a common disease, and may be expected to
destroy ten per cent, of the population (more or less),
there are certain trades so terribly noxious by the
production of irritating dust, that those who work at
them have consumption from five to eight times as
frequently as is usual in other trades.
It is fortunately the case that great relief can be
given by mechanical appliances for carrying off the
dust formed in the process of grinding. The stone
is boxed in and connected with a flue, which rapidly
exhausts the air and its dusty contents from the sur-
face of the stone. Several stones can be connected
with one common flue in this way. The draught is
produced by a fan driven by a small engine of eight
or ten horse-power.
Articles which can be ground wet, as knife-blades,
scissors, etc., do not produce this trouble to such an
extent ; but the artisan is liable to rheumatism and
pneumonia from the wetting of his clothes.
Certain articles must be ground dry, owing to the
necessity of carefully avoiding rust in the finishing
process, as in the case of pins and needles. The
IIO SCHOOL AND INDUSTRIAL HYGIENE.
more extended use of machinery, however, in grind-
ing, has of late done away with most of the injury
from this form of dust.
File-cutters are still exposed to injury from inhala-
tion of particles. You know that machinery is used
to make files ; but a better article is turned out by
Stone-cutters, especially cutters of mill-stones, suf-
fer greatly from this kind of consumption ; and so do
potters. In grinding the materials for earthenware
and porcelain and glass, a great deal of the most in-
jurious dust escapes.
In preparing cotton for use in the mill by beating
and carding, a vast amount of dust is generated ; but
a proper arrangement of draughts ought to remove
the danger of inhalation.
The breathing of coal-dust in the process of mining
changes the color of the entire lung in a few years to
jet-black. This blackening of the lung is not con-
fined to colliers, however, for it is always found in
post-mortem observations of adults, to some extent,
in patches of lung-tissue, and seems not to produce,
ordinarily, any kind of disturbance. There seems,
however, to be no doubt that, when in excess, it may
injure a miner's lung, or, at all events, may aggravate
other diseases. Provision is commonly made for
ventilating mines, which affords considerable relief
to this evil.
INJURIOUS INHALATION. Ill
The chief poisonous substances used in the arts
and inhaled in the form of dust are arsenic, mercury,
In the present state of popular knowledge, little
need be said of the effects of arsenic in wall-papers.
It is quite generally known that almost all shades of
color are producible by arsenical preparations, and
that such are actually among the most popular for
producing the favorite neutral tints of the day, —
green paper being scarcely more dangerous than any
other. It is not the workmen, however, but the cus-
tomers, who seem to suffer from contact with the
arsenical colors; at most, they have certain cuta-
neous eruptions and ulcerations.
It is said to be very hard to bring foreign paper-
makers to terms on the subject of arsenic. There are
importers who faithfully try to prevent the use of such
arsenical pigments ; and it would be just to second
their efforts by legislative action forbidding the use
of arsenical wall-papers altogether. But it will not
be found an easy task to overcome the indifference
of public men to mere considerations of health.
Very few persons die of this sort of poisoning, it is
true. Instead of dying, the unhappy victim (who is
usually unaware of the existence of such a cause) only-
drags out years of wretched invalidism ; and, at last,
if removed from the injurious influence, is only ruined
in health for the rest of life. .. ..
112 SCHOOL AND INDUSTRIAL HYGIENE.
The symptoms of poisoning from arsenical wall-
paper are quite various. They include soreness of
the eyes, catarrh of the nose, throat, and lungs, dys-
pepsia and bowel-complaints, eruptions on the skin,
and great general depression and debility. It is often
noticed that the sufferer is much worse in the morn-
ing, after a night spent in the poisonous room. The
danger is greatest when the colors can easily be
brushed off, and is least when they are protected by
a glazing. But it is impossible to say when danger
begins; and no arsenic should be allowed.
A variety of the papers used for kindergartens
has been found to be highly charged with arsenic.
There is a green, very popular for this purpose, which
almost betrays itself. Can it be necessary to insist
that children of the age of four years should not be
allowed to handle freely so dangerous a substance?
It is perfectly true that many escape. The same is
true of all contagions and poisons, from yellow fever
to the lead contained in drinking water. It is neces-
sary to take such measures as will protect those who
are susceptible, who are likely to be among the most
valuable members of the community. Before wall-
papers are purchased, it would be well to have them
examined for arsenic. Any chemist, or indeed any
intelligent doctor, can easily detect them by Reinsch's
test, at least.
An eruption of the legs, painful if not dangerous,
INJUR IO US INHALA TION. 1 1 3
has been known to be produced by wearing stock-
ings dyed red with coralline, a substance which may
Artificial-flower makers are exposed to the poison
of arsenite of copper or the arsenite and acetate
of copper — Scheele's and Schweinfurth green ; they
inhale it, and receive it by contact with the skin. The
effects are, characteristically, enfeeblement of the
muscular force, especially of the limbs; also a loss
of appetite, palpitation, pain in the stomach, diar-
rhoea, and constant headache.
Mercury is used by hatters to remove hair from
skins. A solution is applied to the skin, and, after
drying in a chamber, the hair is got rid of by beating or
brushing, which liberates a great deal of some mer-
curial compounds. The effects upon the health are
those of chronic poisoning, of which one of the most
prominent is that nervous complaint called mercurial
Mirrors are silvered with an amalgam of mercury
and tinfoil, which when heated parts with the mercury
in the form of vapor. The process is so very inju-
rious that in a certain French manufactory the work-
men worked only six hours in a day, and only on two
or three days in a week. The remedy for the trouble
consists in abolishing mercury and coating mirrors
with silver. A palliative has been found, consisting
in the sprinkling of ammonia on the floors.
114 SCHOOL AND INDUSTRIAL HYGIENE.
In fire-gilding, mercury and gold in the form of a
paste are applied to the surface, and the mercury vol-
atilized by heat ; this gives a much more solid and
enduring surface than electro-plating, and the danger-
ous steps of the operation can now be conducted in
Both mercury and arsenic are driven off by heat
in the process of roasting certain ores. Mercury
seems to be very much the more dangerous to the health,
causing sore mouth, loss of teeth, general debility, or
"cachexia," acute pains, sleeplessness, spasm and
tremor, and paralysis of the muscles, and intellectual
feebleness, besides some symptoms resembling those
of syphilis, eruptions, swellings over the shin-bone,
and glandular enlargement, with deep ulcers of the
mouth and nose. Altogether, the occupation of those
who are forced to inhale mercury is one of the very
Lead is a very common poison — one of the most
common. Its poisonous effects are felt by workers in
lead-mines, by painters, by those who grind and pol-
ish flint glass containing lead, by enamellers, and to
some extent by type-founders and printers. Those
suffer most who have to do with the process of dry-
grinding colors. The "body" which lead gives is
so much thicker than that of zinc that the latter does
not supersede it. You may have seen cases of the
colic which occurs in lead-poisoning. There is an-
INJURIO US INHALA TION. I I 5
other symptom which is more disabling, consisting in
a palsy of the muscles, usually beginning with those
which enable a person to open his fingers and throw
the hand back, so that subjects of this palsy go about
with their wrists drooping like those of a kangaroo
or a begging dog. In fact, it is popularly called
But there are a great many other substances which
produce poisonous or other deleterious emanations.
There are the irritating vapor's of ammonia, chlo-
rine, and several acids — sulphurous, hyponitric, nitric,
hydrochloric, and hydrofluoric acids.
Etching produces fumes of hyponitric acid when
done upon metal, and of hydrofluoric acid when done
upon glass. Both acids are corrosive ; the latter is
excessively so, and affects the eyes, the air-passages,
and the hands.
Bleaching produces fumes of chlorine gas, which is
not injurious in small amounts ; nor is the sulphur-
ous vapor from straw-hat bleaching of much con-
The manufacture of various chemicals is injurious
Those who make sulphate of quinia are liable to
an eruption which resembles eczema, not compro-
mising life or health, but in some cases preventing
workmen from continuing at the trade.
The manufacture of potassium bichromate disen-
Il6 SCHOOL AND INDUSTRIAL HYGIENE.
gages caustic vapors, which destroy the mucous mem-
brane of the nose and produce rapid-eating ulcers
of the skin.
One of the most terrible of diseases is produced by
inhaling the fumes of phosphorus in the process of
making matches — a necrosis or death of portions of
the upper and lower jaw-bones. A surgical operation
is required for the removal of such dead bone. It is,
fortunately, often successful, at least as to life ; but
an infinitely better method is the preventive one.
In addition to this, the fumes of phosphorus pro-
duce catarrhs of the lungs and stomach in almost all
the workmen ; they lose appetite and become pale,
and weak, and thin. There are several precautions
which should be observed, but the chief one is the
substitution of a kind of phosphorus — the amorphous
— which is not poisonous when swallowed, and does
not give off vapors, as common phosphorus does, at
the ordinary temperature of the air.
Women suffer more than men from several of the
poisons we have named. They not only lose their
health more readily, from a greater susceptibility to
morbid influences of certain kinds, but their sexual
system is very liable to be injured. "They are much
more susceptible than men to the influence of mercu-
rial vapors, and those who are poisoned abort fre-
quently, and even the children that are born to them
are apt to be weak, sickly things, and die early."
INJURIOUS INHALATION. W]
The infants of female operatives in certain branches
of china-making are almost all scrofulous, with an
enormous mortality. Lead affects women more read-
ily and more seriously than men. They suffer from
excessive flowing at the monthly period, and have
frequent abortions. With regard to workers in to-
bacco, it is stated by Tracy, of New York, that they
have very small families; quite the reverse of what is
usually the case with working-people. He found
only four hundred and sixty-five children in three
hundred and twenty-five families. It is not certain
what the cause of this peculiar condition may be; but
it is quite probably due in large measure to a prema-
ture commencement of work, and to an influence
which tobacco has in checking the sexual develop-
ment of young girls.
Tobacco is such an interesting subject that it is
hard to avoid saying more. It will be safest, how-
ever, to say but little, for we know that the whole
subject of tobacco is to some extent an open one. It
is hard to prove that the drug is injurious to health in
the case of most adult persons who chew or smoke
it, or of most operatives ; but there are some who are
seriously, if not permanently, injured by it ; and it is
certainly desirable to keep young persons under six-
teen from its use.
The chief practical points, in the prevention of dis-
ease arising from dust, whether poisonous or not, are :
Il8 SCHOOL AND INDUSTRIAL HYGIENE.
1. Removal of dust by ventilators, mechanical fans,
etc. This is enjoined by the English law of 1878.
2. Wet-grinding, grinding in close vessels, etc., is
3. The wearing of masks over the face, composed
of wire-gauze, wire frames covered with tarletan, res-
pirators of carded cotton, etc. ; but these are hot and
4. If working with poisonous substances, the work-
men should wash the exposed parts — face, hands,
hair, beard — on leaving work, especially before eat-
ing, and should never eat in the work-room. After
work, they should change their outer clothes, and a
daily bath is very desirable in some occupations. To
protect from lead and other dusty poisons, a linen
suit, frequently washed, may be worn.
The effects of certain poisons on the female sex and
on children are so injurious that special laws are re-
quired to restrict their employment in manufactures
where poisons are used. The restrictions of the Eng-
lish Factory Act of 1878 are as follows:
No woman, or person under sixteen, shall take
meals in any part of glass-works in which the mate-
rials are mixed, or where flint-glass is made, or where
grinding, polishing, or cutting is carried on ; or in
any part of lucifer-match works in which any manu-
facturing process or handicraft (except that of cutting
the wood) is usually carried on ; or in the dippers'
INJUR 10 US INHALA TION. I 1 9
room, dippers' drying-room, or china scouring-room,
in any earthenware works.
There is absolute exclusion from labor in the fol-
lowing cases : girls under sixteen, not allowed to be
employed in an establishment where bricks or tiles
(not ornamental tiles) are made or finished, or salt is
made or finished. No child under fourteen to be em-
ployed in a part of the building where dry-grinding
in the metal trade, or the dipping of lucifer-matches,
is carried on ; under eleven years, all metal grinding
is forbidden, and fustian cutting. Persons under six-
teen are forbidden to work at silvering mirrors by the
mercurial process, or at making white-lead. Children
under fourteen and girls under fifteen are excluded
from parts where the process of melting or annealing
glass is carried on.
INJURIES FROM ATMOSPHERIC CHANGES.
THE unquestionable benefit which free exposure to
the air in all weathers confers is subject to cer-
tain drawbacks. It is not necessary to consider sun-
stroke, in the case of day-laborers, nor accidents by
falling from roofs, or from railroad collisions, as
forming an element in "industrial hygiene;" but
there are certain causes which affect the health per-
manently, as bronchitis and pneumonia ; and to this
may be added a liability to paralysis of the facial
nerve, which is especially the possession of drivers of
Bronchitis and rheumatism are common enough
also among those whose trade exposes them to great
heat, as blacksmiths, stokers on steamships, forge-
men, puddlers, glass-blowers, dyers, and washer-
women. It is, in fact, neither heat nor cold that
causes the trouble, but excessively rapid transitions
from heat to cold.
The trade of baker is apt to be very unhealthy,
owing to the confined, close, dark, overheated quar-
ATMOSPHERIC CHANGES. 121
ters in which it is carried on; also the night-work,
and occasional excess of work.
There is a peculiar and interesting class of disease
which attacks those who work in diving-bells or cais-
sons. It is caused by the excess of atmospheric press-
ure which exists under water, which may equal several
times that to which men are exposed on land. The
symptoms do not, however, attack the laborer on going
down, but rather on leaving work. The case, in fact,
is parallel to that of the aeronaut when he rises in
his balloon, or the climber of mountain peaks. The
symptoms, dependent upon the removal of pressure,
are as follows : Extreme pain ; sometimes nausea and
vomiting; sometimes paralysis ; sometimes headache
and dizziness. They are frequently associated with
a sudden rush of blood to the brain and spinal cord.
The precautions to be observed are quite interesting.
It is recommended that only wiry men be selected for
the work ; that their time of labor be shortened in
proportion to the pressure ; that they take all possi-
ble care of themselves, never going to work on an
empty stomach, eating meat and drinking coffee, and,
when coming out of the caisson, taking time to do it
gradually, passing into an intermediate atmosphere
first, and resting an hour afterwards.
Miners. — The health of a miner is exposed to
special causes of injury. In addition to the danger
of being blown up, or knocked down by falling
122 SCHOOL AND INDUSTRIAL HYGIENE.
stones, he is constantly at work in the presence of
great masses of minerals which generate noxious
gases, — not to mention the effluvia which arise from
his own person, the flame of his candle, and the burn-
ing of powder. To this is added, in many cases, an
excessive heat, often a steaming, sultry heat, or else
a continual cloud of dust proceeding from the coal or
rock under the blows of his pick. And if we further
consider the confined position in which he often
works, the excessive exertion, the exposure to draught,
and the total deprivation of sunlight, we shall be
ready to admit that his life is an unnatural one, and
full of singular risk.
But man can adapt himself to almost anything.
With proper precautions, it is said that the life of a
miner is almost as safe, and his health quite as good,
as those of other classes in general ; better, in fact,
than those of his own family. If this be so, it is
certainly a great triumph of the hygienic art.
The precautions to be taken relate first and fore-
most to ventilation.
" Fire-damp" is a name given to light carburetted
hydrogen, which is given off abundantly in the car-
boniferous strata and in enormous quantities from the
Pennsylvania gas-wells. In the English coal-mines
it is much more abundant than it is at present with
us. When mixed with seven or eight times its own
volume of common air, it is highly explosive. After
ATMOSPHERIC CHANGES. I 23
an explosion, the passages are filled with the irrespira-
ble mixture of nitrogen, carbonic acid, and the vapor
of water, resulting from its combustion.
"Choke-damp," or "black-damp," is a name for
carbonic acid, a common product of most combus-
tions, and of respiration. It abounds in badly-ven-
tilated mines. Nitrogen is not a poison, by itself.
Carbonic oxide, however, is one of the most danger-
ous of poisons, and so is sulphuretted hydrogen when
present in any considerable quantity. Both the latter
are called "white-damp."
The heated flue, as a means of exhausting air from
mines, has obvious dangers in coal-mines; and its
special disadvantage lies in the variations which dif-
ferent atmospheric conditions produce in its working.
The steam-fan, driven by a small engine, may be
used either for drawing air from the mouth of a mine
or for forcing it in through tubes to the places where
it is most needed. It is, altogether, the best means
of ventilating mines.
Another reason for supplying abundance of fresh
air to mines is furnished by the great heat which is
found under ground. In the Cornish mines, the tem-
perature is said to increase regularly about one degree
Fahrenheit in every fifty feet in the upper parts, and
one in every eighty-five feet in the lower parts ; and
this is, with local exceptions, nearly the rate at which
the temperature rises in other mines. Some of the
124 SCHOOL AND INDUSTRIAL HYGIENE.
exceptions, however, are very remarkable. The deep
levels of the mines on the Comstock Lode in Nevada
have temperatures varying from 105° to 130° Fah. ;
and this excessive heat is mitigated by blowing upon
the men fresh air at 90 or 95 , which seems to be
most conducive to comfort. The men, under these
circumstances, work with great vigor, but have to be
This great heat is said to be very productive of
heart-disease. There is no doubt that this effect is
intensified by excessive barometric pressure and by
dampness of the air, preventing evaporation from the
body. It is affirmed that the system in use at the
Comstock is so thorough as to do away with most of
the danger from all of these sources.
To spare the men a needless and wasteful expen-
diture of bodily force, it has been found best to use
cages worked by engines to raise and lower those who
are going to or from work.
The excessive quantity of coal-dust which chokes
the air of badly- ventilated mines has been previously
alluded to as affecting the lungs. But there are other
causes of pulmonary trouble, quite obvious in their
nature, such as sudden changes from heat to cold,
and deliberately sitting down in draughts to cool off
after working in the high temperatures mentioned.
On the whole, the principal diseases are miners' asth-
ma, consumption, and rheumatism, and, among those
ATMOSPHERIC CHANGES. 125
who have worked long in badly-ventilated places,
dyspepsia, tremors, vertigo, and other troubles arising
As regards accidents, they are due to a great many
various causes ; but more than one-half of them, in
the Pennsylvania coal-mines, are caused by falls of
rock, coal, or slate. It is the opinion of good judges
that a very large number of these casualties could be
avoided by sufficient timbering of the roofs and sides.
One and a quarter in every hundred, or 12 \ men in
every 1000 employed in these mines, are killed or
wounded every year by accidents ; and it seems that
here is a distinct and obvious field for a humane reform,
either by legislation or by private effort.
Soldiers and Sailors. — In most of the European
services great numbers of the men used to die of con-
sumption and allied diseases, and fevers, probably
chiefly typhoid. This lamentable result was not in
the least due, however, to exposure to weather, but to
what may be called a contrary condition — the want of
fresh air in barracks. In certain of the best English
regiments the losses were from one-third more to twice
as great as among men of the same age in civil life.
The fearful loss of life from disease in the Crimea is
well known ; and it is from that time that the reforms
date which have brought down the total rates of death
from disease to one-half of what they were. The
126 SCHOOL AND INDUSTRIAL HYGIENE.
present allowance in England is 600 cubic feet of
space to each man in barracks.
The ills of sailors are, to a very great extent, caused
by want of fresh air, dirt, and dampness. It is com-
monly forgotten that, by washing down the deck fre-
quently, a source of disease is introduced which is at
least as dangerous, and in feverish localities ten times
more dangerous than simple dry dirt. Good ventila-
tion and scrubbing and drying are the cure for the
chief of the curable ills of ship-life.
INJURIES FROM OVER-USE OF CERTAIN ORGANS.
IT is as true of the mind as it is of the body, that no
one part can be exclusively used without injury to
the individual considered as a whole. In the broadest
possible division of our being, neither "mind" nor
"body" has a right to exclusive cultivation; and
such exercise is never in the interest of the best phys-
ical health. The same is true if we subdivide the
faculties of body and mind. There are many ways
in which the mind is exercised in daily life : book-
study, concentration of attention on discourse, mem-
orizing, reproducing, extemporary discourse; atten-
tion to great single questions in business, and to mul-
titudes of petty ones ; ciphering and copying by the
day, and the vivid, sudden, mortal collisions of the
street. None of these can properly be kept up to the
exclusion of the others, unless there is a strong pre-
disposition and fitness on the part of the individual :
they should alternate with one another, for most per-
sons are incapable of sustaining continued strain in one
of these points. We say that " worry " kills a man;
128 SCHOOL AND INDUSTRIAL HYGIENE.
but in saying so we mean simply that the mental ex-
citement upon one subject, which is perfectly health-
ful if continued for a few hours, becomes tyrannical
and destructive if kept up for whole days. A man
may be worried into illness by incessant, quiet cipher-
ing as well as by attendance at the Brokers' Board.
The care of the mental health has been sufficiently
treated of in another of this series of Primers.* It
is my purpose here briefly to mention some muscular
affections which are caused by monotonous and ex-
The robust activity of the blacksmith and carpen-
ter do not exempt them from the general law. They
are liable to a disease termed "hammer-palsy," af-
fecting the muscles which are overworked.
A painful and very unfortunate affection sometimes
attacks those who write a good deal. The premoni-
tion is given sometimes by pain in the muscles em-
ployed in holding the pen. There is apt to be a
nervous condition of the system, a tendency to
anxiety ; but this is not always the case. As seen in
its typical form, the disease presents no token of its
existence until the person affected begins to perform
one special act, as, in the present instance, the act of
writing. There may be great muscular vigor, and
complete control of all the faculties and motions
* " Brain-Work and Overwork," by H. C. Wood, M.D.
OVER -USE OF ORGANS. \2<)
except one ; but as soon as the patient undertakes to
grasp the pen and write, he finds his fingers in a state
of cramp ; they pinch the pen excessively, or they fly
back from the pen, making it impossible to hold it.
It is very desirable that this should be recognized in
an early stage, as it is a malady somewhat difficult of
cure, and absolutely disabling as respects clerical
work. Some reader may thank me for saying that
electricity has been applied of late with good success
to the treatment of Writer's Cramp or Palsy.
The affection here described is not confined, how-
ever, to writers, but affects also pianists, violinists,
engravers, seamstresses, telegraph-operators, tailors,
type-setters, and many other classes who use one set
of muscles almost exclusively.
The theory has been put forward that writer's cramp
is caused by an electric current generated in a metallic
pen, or by the contact of pen and holder. This can-
not be admitted. The disease is fundamentally the
same, whether caused by work with the pen or on
catgut or ivory. But a steel-pen may be found inju-
rious, and can be replaced by gold or quill; or a
large pen-holder may be used, made of cork, of the
size and shape of a large cigar, which is felt by many
to be a great comfort in writing. A departure from
the prescribed mode of holding the pen, and placing
it between the forefinger and the middle finger, may
also be a relief. Dr. Frank Woodbury, of Philadel-
I30 SCHOOL AND INDUSTRIAL HYGIENE.
phia, has lately invented an ingenious pen-holder to
prevent writer's cramp, by regulating the pressure at
which the pen is used by a slight spring. But if the
disease has developed itself, no such palliation is of
any avail ; and if the sufferer learns to write with the
left hand, as has been done, the left hand also is liable
to be attacked. The temporary use of the "type-
writing machine " will often prove a great boon, per-
mitting a continuation of work while resting the af-
The effect of using sewing-machines is sometimes
injurious. It is not worth while to mention any
special effects. The muscular exertion, however, is
of a monotonous character, and may produce mus-
cular fatigue which is prejudicial to the general
health. It has been known to cause neuralgia of the
foot and leg. In general, the use of the machine two
or three hours a day is probably beneficial to most
women ; but a whole day's work, if the machine is
run by the feet of the worker, is far too severe, and
steam-power had better be used. Much has also been
done by applying the principle of alternate effort, by
a treadle which is moved both by the downward and
the upward movement of the feet, and employs both
feet at once or one at a time, at will. Many will
find relief by alternate basting and sewing each for
twenty to thirty minutes.
Steam-power has been applied with success to run-
OVER -USE OF ORGANS. I3I
ning sewing-machines. I am told by the head of a
large manufactory of ladies' dresses that the machines
do one-third more work than when run by the foot;
and that the girls will work for less wages when steam-
power is used.
Those who use the voice a great deal in public
speaking and singing are apt to suffer from the strain.
The most common affection is follicular pharyngitis,
or "clergyman's sore-throat." Much of this trouble
is unnecessary, strictly speaking, or could be remedied
if the right steps could be taken. The voice ought
not to be used for continued and difficult efforts, un-
less the possessor is in good health and strength. It
ought not to be used in the crude, ignorant, and even
unintentionally "affected" manner which is often
heard, and which fatigues the throat without need.
The services of a competent teacher in elocution are
to be desired, not so much for rhetorical purposes as
for training in the right way to work with the vocal
organs. And by way of support, a little gymnastics,
for developing the chest, shoulders, and abdomen,
may properly accompany the process of developing
the voice, in some cases.
This is a fit place for a brief mention of the inju-
rious effects of protracted labor in one position.
Shoemakers and tailors, owing to their constrained
attitudes, and the bad air of their shops, become
dyspeptic, anaemic, and consumptive, and do a great
132 SCHOOL AND INDUSTRIAL HYGIENE.
deal more thinking than is good for them. The
sedentary life of literary people and clerks is apt to
affect them similarly.
Persons who stand all day at their work, as sales-
people and hair-dressers, are apt to have pains in the
soles of their feet, which may sometimes be relieved
by a well-shaped steel-shank to the shoe. Varicose
veins of the lower limbs, and uterine irregularities,
are also caused by standing. It is a truly inhuman
thing to require girls and women to remain on their
feet all day, without regard to the presence or absence
of customers — an inhumanity that we are glad to
believe is diminishing.
INJURIES FROM ACCIDENTS.
VERY considerable number of accidents are
caused every year by machinery used in manu-
facture. In England, in 1875, 2 -6 persons in every
1000 factory-hands were injured in this way. In the
United States there were 420 reported deaths caused
by machinery in 1870, and the number of injuries
was of course very much greater.
The English Factory Act appoints inspectors, who
must not be interested in or connected with factories
in any other way, and who are invested with the
necessary powers for carrying the act into effect.
Some of the provisions of the act are here given,
from an abstract published in Professor William Wat-
son's paper in the Journal of Social Science, No. XI.
Certain portions of a mill, as hoists, fly-wheels,
wheel-races, mill-gearing, vats, etc., are required to
be fenced, and whenever the machinery, by reason of
its character or situation, is, in the opinion of the
inspector, likely to cause accidents to the work-
people, he is to serve on the occupier a notice
«2 • »33
134 SCHOOL AND INDUSTRIAL HYGIENE.
requiring him to fence the part of the machinery
which he deems to be dangerous. The occupier
may, by serving a requisition on the inspector within
seven days of the receipt of the notice, refer the mat-
ter to arbitration.
A child (under fourteen) is not allowed to clean
any part of the machinery of a factory while in mo-
tion. A young person (from fourteen to eighteen) or
woman ("over eighteen) is not allowed to clean such
part of the machinery as is mill-gearing, while the
same is in motion. A child, young person, or woman
is not allowed to walk between the fixed and travers-
ing part of any self-acting machine while the same is
Accidents causing death, or disabling the person
more than forty-eight hours, must be reported to the
inspector and visiting surgeon by the occupier of the
factory or workshop. The surgeon is to examine at
once the nature and cause of the accident, and report
to the inspector within twenty-four hours.
Neglect to keep a factory or workshop in conformity
with the act is punishable by a fine' not exceeding
_j£io ; and the court (of summary jurisdiction) may
inflict a fine, not exceeding ^100, for the benefit of
the injured person or his family, or otherwise, in case
of death or injury in consequence of neglect to fence
machinery as required.
Professor Watson, in the same paper, gives a very
INJURIES FROM ACCIDENTS. 1 35
interesting account of an Association for the Preven-
tion of Factory Accidents, existing at Mulhouse, in
Alsace. It consists of twenty-four members, com-
prising mill-owners, superintendents, manufacturing
engineers, foremen, and workmen chosen by the In-
dustrial Society of the city, with the aid of the work-
men. The Association offers arbitration, in cases of
claims for damage, and uses various means for spread-
ing a knowledge of the dangers and their remedies.
At the Paris Exposition of 1878, they exhibited twen-
ty-seven examples of contrivances adapted to prevent
very severe accidents such as commonly occur,
especially from belts, shafts, pulleys, wheels, and
circular-saws. It would be well if our employers of
labor in large manufacturing centres, such as Phila-
delphia, Fall River, Lowell, etc., would imitate this
Railway accidents may be properly mentioned in
this place, for they affect the employes in vastly
greater proportion than the passengers. For instance,
in France, from 1854 to 1869, the number of travellers
killed and wounded on railroads was 2,832; but that
of employes was 11,908. If we consider how few
men are required to run a train carrying hundreds of
passengers, we cannot help being struck with the
REGULATION OF HOURS OF LABOR.
THE application of machinery and steam-power to
the manufacturing arts has made England the
richest country in the world. But this wealth was
attained, at first, at a cost of human suffering and
death which makes a sad page in history ; a page
which, fortunately, has not been paralleled in our
country. No system of labor has existed here, upon
a large scale, by which a boy of eight years could be
carried daily to work for sixteen hours in a mill, with
half an hour for meals. We have not seen large
numbers of little children beginning a full day's
work at six years of age ; nor have we frequently
seen the consequent distortions and deformities
known in England as the "factory-leg," due to
standing an excessive length of time. No large
numbers of women here work all day, leaving little
infants in the charge of baby-farmers.
It is useless to expect that these things will always
go right of themselves. The absence of legislation
on hours of labor, for the protection of women and
REGULATION OF HOURS OF LABOR. 1 37
children especially, is excusable in some of our States,
on the ground of the subordinate nature of the in-
dustry. But the want of uniformity which is seen in
the laws of States which have attempted statutory
regulation is a little startling, and obliges us to infer
that American views are not so definite on some prac-
tical points as they might be.
From a communication sent me by Dr. Roger S.
Tracy, of the New York Board of Health, I compile
the following statements, which will give a nearly
complete idea of what has been done hitherto. Dr.
Tracy examined the statistics of the twenty-eight
principal States, and found the following: —
Factories. — Labor forbidden to children under 10
in Massachusetts and New Jersey; under 12 in Rhode
Island and Wisconsin ; under 13 in Pennsylvania.
Coal-mines. — Labor forbidden to children under
12 in Pennsylvania; to children under 12 and all
women in Illinois, and under 14 in Colorado.
Factories. — Over ten hours' work daily forbidden
to children under 14 in Michigan ; 15, in Connecti-
cut; 16, in Maine and Maryland; 18, and all women,
Factories. — Over eight hours' daily work forbid-
den to all under 18, and to all women, in Wisconsin.
Educational, requirements are made in eight of the
twenty-eight States. The strictest are those of Wis-
I38 SCHOOL AND INDUSTRIAL HYGIENE.
consin, where children are not to be employed while
the public schools are in session.
This is about all that has been done in our country
for the protection of women and children from ex-
cessive and improper labor. There are laws relating
to the employment of children in fourteen of the
twenty-eight States ; but a large number of the laws
relate to educational and not to sanitary points.
It is certainly a singular discrepancy that, in Mas-
sachusetts, parents are allowed to send a child of ten
years old to work ten hours in a factory, while in
Wisconsin only eight hours of labor are allowed at
the age of twelve to eighteen.
The English legislation has been thorough and en-
lightened, showing upon the part of its authors a
degree of humanity, painstaking, and intelligence
which go far to atone for previous sins of neglect.
Its provisions are as follows: —
Children under 10 shall not be employed in any
factory or workshop.
A medical certificate is required, in the case of all
persons under 16, of the fitness of such persons for
employment in the factory specified. The employer
procures this certificate, and is responsible for proving
the age. The Government Inspector may require a
certificate, if a person under 16 seems to him unfit,
and may forbid his working again until recertified
by the certifying surgeon. The examination is made
REGULATION OF HOURS OF LABOR. I 39
at the factory. Refusal to give a certificate must be
accompanied by written reasons.
Persons under 14 shall not be employed on Sunday
in workshops or factories. Christmas, Good Friday,
and eight half-holidays besides, are given.
Children are employed (under 14) under one of
two plans : — (a) in alternate sets, morning and after-
noon; (J>) on alternate days. The morning work ends
at 1, or at dinner if earlier. The afternoon work
begins at 1, or after dinner if later. The day is 12
hours long, viz. : from 6 to 6, or 7 to 7, for children,
voung persons, and women, with ij hours for meals.
On Saturday the day ends at 2 o'clock.
Children must not be employed more than five
hours continuously without a meal (half-hour). All
must eat at the same hour (children, young persons
under 18, and women), and never where work is
Every child under 14 in a factory or workshop
must attend a school, either on the alternate off-days
or on the half-days when off work. If he fails to
attend in any week, he shall not recommence work
the next week until he has made up his absence from
school. The employer obtains certificate of attend-
The parent selects the school. Proficiency in the
elementary studies, which satisfies a certain standard
I40 SCHOOL AND INDUSTRIAL HYGIENE.
fixed by Government, enables a child at 13 to work
as if over 14, — as a "young person."
The school is authorized to collect its fees from the
occupier of the factory, to a certain extent, the
amount to be deducted from the child's wages.
It is not in my power to say whether the health of
the rising generation is suffering from overwork or
confinement in factories in our States. There is not
much evidence to prove it. The investigation pub-
lished in the Massachusetts State Board of Health
Report for 1871 is not at all alarming in its results.
It found that " the correspondence in death-rates be-
tween the factory population and the whole popula-
tion, at the same ages, was so remarkably close as to
leave but little to be said " (page 422).
There is in modern labor a tendency to aggregate
persons and resources in great masses, which pro-
duces town-life, large enterprises, and great factories.
In many ways this is to-be deplored; but it is right
to see the bright side also. The old system of inde-
pendent workshops, where the weaver or other me-
chanical toiler spent all the time he could possibly
give in small, crowded shops, often in his own room,
in narrow and nasty quarters at the best, has given
way to the system of large shops, which are run for a
much smaller number of hours, are far better lighted
and warmed and aired, and, what is perhaps the root
of the whole matter, are much more accessible to the
REGULATION OF HOURS OF LABOR. I4I
control of public opinion and to legislative inspec-
tion. It is in the large shops that you find the large
brains at the counting-desk — men who can under-
stand sanitary needs, and are not hampered by the
petty necessity of domestic economy which weighs
down the solitary workman. It is the large establish-
ments that take the trouble to answer questions upon
sanitary matters addressed to them by the State au-
DURATION OF LIFE IN VARIOUS OCCUPATIONS.
AS everybody would like to know that he has a
prospect of long life, everybody has a certain
curiosity in regard to the statements of science con-
cerning the effect of his own work on the duration
of life. There are a good many facts going the
rounds, and if taken with allowances for the circum-
stances, these facts are valuable. But there is so
great a contradiction between the statements of dif-
ferent authors, that the most meagre statements are,
perhaps, the safest.
From Hirt's tables I select a typical trade or two to
represent each period of life, dividing life into periods
of five years. My selection is, of course, arbitrary.
Among the operatives who die on the average be-
fore the age of 40 years, I find porcelain-turners,
stone-cutters, and female mirror-makers.
Under 45, goldsmiths, lead and quicksilver miners.
Under 50, cabinet-makers and operatives in cotton-
mills — not very wholesome, and not particularly
Under 55, to my surprise, come some trades which
I should have put much lower. Needle-polishers are
DURATION OF LIFE. 1 43
said to average 50, file-cutters 54, engravers 54.6,
and so forth. It is possible that a good many classes
fall in here simply because it is rather a medium age
at which to die, independently of other circumstances.
Under 60 years (also a good medium age, on the
favorable side,) we find blacksmiths, butchers and car-
penters, machinists and turners, the watchmaker who
measures our life for us, and the grave-digger who
takes our measure for the last time.
Under 65, it is interesting to find set down the
classes of tanners, dyers, gas-men, catgut makers, and
bone-boilers — trades which may remind us that long
life is not to be attained by shirking disagreeable or
Above 65, only three trades are mentioned.
In England, the rates of mortality among different
classes have been estimated by Dr. Farr, who states
that the shortest lives are found among earthenware-
makers, tailors, needle-makers, makers of files and
saws, veterinary surgeons and farriers, railway em-
ployes, coachmen and cabmen, commercial clerks,
butchers, publicans, innkeepers. A good deal of this
mortality is due to habits of excessive drinking and
exposure to the weather.
Physicians and surgeons, chemists and druggists,
mercers and drapers, hair-dressers, barbers, wig-mak-
ers, and hatters, miners, and some others, have a high,
but not an excessively high, rate of mortality. Carv-
ers and gilders suffer less than they did ; and manu-
144 SCHOOL AND INDUSTRIAL HYGIENE.
facturers of wool, silk, and cotton no longer experience
an exceptionally high mortality, owing to the zealous
efforts made by Lord Shaftesbury and his enlightened
colleagues in promoting sanitary legislation.
Among the healthy classes may be named carpen-
ters, wheelwrights, and workers in wood generally ;
shoemakers, grocers, publishers, and booksellers.
Among the healthiest and longest-lived are the
agricultural classes, game-keepers, barristers, and the
clerical profession. But solicitors and Catholic priests
in middle and later life form exceptions.
Metal workers, in the aggregate, do not experience
the average rate of mortality under 45, but after this
age the case is reversed ; miners have a still higher
rate, and both classes have a much higher rate than
From the " Massachusetts Registration Reports" I
will quote the following statement of the average age
at death of nine general classes of men, the average
of all classes and occupations being 50.94 years :
Average Age at Death.
Cultivators of the earth .
Active mechanics abroad
Merchants, financiers, agents, etc.
Active mechanics in shops
Laborers, no special trades
Employed on the ocean .
Inactive mechanics in shops
Factors laboring abroad .
The following works on gymnastics may be named
as useful :
Manual of Gymnastic Exercises, arranged on Hygienic Prin-
ciples and adapted to music. By E. H. Barlow. Amherst,
Manual of Gymnastic Exercises for Schools and Families. By
Samuel W. Mason. Boston, 1863.
Handbook of the Movement Cure for Prevention of Spinal
Deformities. By M. Roth.
How to Get Strong, and How to Keep so. By William
Training in Theory and Practice. By Archibald Maclaren.
13 K '45
Aoortion caused by mercurial
from lead poisoning 117
Accidents I33 -I 35
legislation to prevent. 133, 134
precautions 134, 135
on railways 135
in mines 125
Adams's statistics of distorted
Afternoon schools 61,62
Age, as determining capacity for
study 31, 32
Air, quality of supply for turnace 86
overheated 86, 87
from cellars 91
American desks and seats for
factory and mining legisla-
Amherst College gymnastics 44
statistics of near-sight 58
Anxiety injurious to health 14
Apparatus for gymnastics 36
Appetite, failure of, sign of over-
Application, capacity for contin-
uous mental, at different ages.. 30
Architectural ornament subordi-
nate to hygienic requisites 84
Arsenic in wall-paper 111, 112
chronic poisoning, symp-
in kindergarten paper 112
in stockings 113
in artificial flowers 113
— — in certain ores 114
Astigmatism mistaken for short-
Atmospheric changes, injury
from 120-126, 143
Attention, power of, at different
Back, support for 68, 78
Base-ball, when injurious 38
Bigelow, H. J., on chairs 68
Blackboards, position 83
Boarding-schools, some good ef-
fects on health 23
See pages 98-101.
for girls 100
Boards of Health, duty in conta-
gious diseases in schools 100
Bodily development, when com-
Bowling, when injurious 39
Boys, rate of growth 24
Brain, constant repair of 28
Breakfast neglected by children.. 17
study before 20
Brooklyn, statistics of near-sight 58
Brown, Buckminster, injury
caused by military drill 46
on origin of spinal de-
Buffalo, statistics of near-sight... 58
Caisson disease 121
specimen of 46
Carbonic oxide from furnace 87
Carter, Brudcnell, on care of eyes 48
Carter, Brudenell, on near-sight. 60
Cellar air 91
water-closets in 96
Chadwick, Edwin, on hours of
study „ 29-31
Chair-back, main use 68
Children, mental characteristics
7.. 2 9. 3°. 3i
requirements in exercise 35
bodily peculiarities 61
sickliness owing to mothers'
trade 116, 117
legal restrictions on labor...
China-makers, scrofulous chil-
Cincinnati, statistics of near-
City life, injurious to health of
Clarke, E. H., on sex in educa-
Clergyman's sore throat 131
Closets for scholars' clothing 84
"Clothing 40, 44, 47, 93
Coal-dust inhaled no
Conn's statistics of near-sight 57
■ for girls 100
study in 32
Color of walls 83
Commons at college 104
Competition between girls and
Comstock lode 124
Congestion as a cause of near-
Conklin, effect of school-life on
Consumption caused by inhaling
among miners 124
Contagious diseases 105, 106
of eyes 63
Cotton-mills, dust no
Croquet, how injurious 39
Cubic space required in school-
Cubic space for dormitories 99
■ in barracks 126
Culture, its true scope __ 10
Curvature. See Spinal.
Dampers of furnace 86
Danneberg on gymnastics, at
Dayton, Ohio, statistics of near-
Deafness often misunderstood by
Decoration of school-room 83
Deformities from factory-work... 136
Derby, Hasket, statistics of near-
Desks, faulty construction.... 65, 66
height of. 74
assorted sizes 74
Development. See Growth.
Diet of school-children 17
See Food, Commons.
Dinner, time for 21
Discomfort as a cause of deform-
Discontent, effect on health 14
Distance for reading, etc. 49, 53, 54
Dormitories in schools 99
■ — — in colleges 104
bad position in 64
Dress for gymnastics 40, 44
Drill of scholars 95
Drudgery of schools 15
Drunkenness, mortality from 143
Duration of continued mental ap-
of life in various occupa-
Dust, poisonous 111-119
prevention of 109, no, 117, 118
Duty, unregulated sense of..... 8, 11
training of sense of. 9
Earthenware makers no, 143
Education, principles and theo-
ries of; 7, 13
claims the whole child 8, 10
Education should include morals
and health 9, 10
should develop power, en-
durance, self-control n
should develop spontaneity 29
Educational legislation i37 - *39
Elbows on desk 70
Emotional strain upon pupils .... 14
Emulation, its power 8
injury from 8
methods of arousing it 16
England, half-time system 32
English Factory Act of 1878
118, 119, 133, 138-140
Equilibrium of mental powers,
when disturbed 14
Erismann on size of school-room.. 79
Eulenberg's statistics of distort-
ed spines 37
Evaporation of water 87
Examinations of schools 17
Excess of study defined 28
Exercise, physical 34~47
adapted to different temper-
by walking 34, 35
J- J- Putnam on 38
by military drill 46
See Walking, Gymnastics, etc.
Exhibitions of schools 16, 17
Explosion of gas 122
Eyes of young children allowed
to wander 61
care of. 48-63
ignorance of teachers about 48
Brudenell Carter on care of. 48
near-sighted 48, et seg.
distance from book... 49, 53, 54
effect of general weakness
of disease upon 52
See Near-sight, Weakness,
Factories, English 136
— — American.; 137
Factories, health of operatives... 140
Farr on life statistics 143
simulating near-sight 51, 55
Fatigue not the prime object of
Fevers, prevention of spread 105
File-cutters no, 143
Fire on the hearth, principles of 88
Fireplace, aid to ventilation.. 88, 98
See Open Fire.
Floor of school-room 84
Follicular pharyngitis 131
Food 19, 23
deficient supply 22
See Commons, Meals.
Frankfort, public school gymnas-
tics 41-4 (
Furnace, supply of air to 86
should be large 86
producing carbonic acid 87
water for 87
Furniture for schools. See Desks
Gas-light, ventilation of. 87
Gas. See Explosion.
German school-seats 67.68
Girls, rate of growth 24
— — competition with boys 25
about age of 14 and 15, spe-
cial care of. 25, 26
injured by " society" 26
choice of gymnastics for 43
should not have to climb
many stairs 95
Glasses should be worn by some
children 60, 63
to be selected by physicians
when to be worn by children 69
Glass-makers no, 114
Grinders' asthma 108
Grinding, wet and dry 109
glass n 4
■ colors , 114
Ground glass 83
Growth of body 24, 27, 35
Gymnastics, Ling's system of..... 41
for girls 43
in Amherst College 44
in normal schools 44
in colleges 102, 104
precautions in 103
teacher for 103
for boating-men 103
Habits of health taught i n
Half-time system of education
in England 32, 62, 139
Harlan, diagram to illustrate
Health, laws of, taught in
Heart-disease in miners 124
Heat of mines 123
Heating. See Ventilation.
High-schools, study in 32
Hirt's life-statistics 142
Holidays in factories 139
Horseback exercise sometimes
Immorality in schools 99
Inhalation of dusty and poison-
ous substances 107, 119
Ink, pale, bad for eyes 57
Inspection of schools by medical
authority 45, 106
Irksome tasks 15
Janitor's duties 91
Juvenile labor on half-time sys-
tem , 3 2
Keen, W, W., ventilation 92
Kindergartens 29, 35
green papers 112
Konigsberg, statistics of near-
Lead-poisoning 114, 115
Lead, effects on women 117
Legislation. See English Fac-
tory Act, Restricti ons, Women,
Length of life 142
Liebreich, construction of desks
and seats 67, 77
on spinal curvature 74
Life, duration of. 142, 144
Light, defective, causes stooping 69
horizontal useless in read-
what constitutes good 82
dazzling eyes at work 83
direct rays of sun 83
in private house .- 98
See Windows, Shades.
Ling's system of gymnastics 41
Long-sight. See Far-sight.
Lonng. E. G., and R. H. Derby,
statistics of near-sight 58
Lot, size of, for school 94, 95
Lunch for children in school 22
Lungs affected by inhaling dust,
Maine ventilation 92
Maps 56, 57
Masks to protect from dust 118
Massachusetts Registration Re-
port on average age at death.. 144
State Board of Health on
prevention of spread of conta-
gion in schools 106
State Board of Health on
health of operatives 140
Meals, interval between study
intervals between 21
sleepiness after 21, 22
in factories 139
Medical inspection of schools,
Mental application, excess de-
fined . 28
characteristics of children... 7
depression a symptom of
Mercury, effect on hatters 113
— ■ -. — r mirror-makers 113
Mercury, effect of on gilders 114
symptoms of chronic poison-
effect on women 116
Military drill in schools 46
Miners 121, 125, 143
Morality taught in schools 8, 9
Mulhouse, Association for the
Prevention of Factory Acci-
Muscles, affections caused by
Music, practice 101
Myopia. See Near-sight.
Near-sight defined 49
tends to increase 49
prevention of increase... 50, 52
things mistaken for it.... 51, 54
causes of. 51, 53
inheritance of. 51
pathology of 51
favored by weakliness 52
bad air 52
is not strong-sight 53
dangerous tendency of. 53
Harlan on 54
caused by fine work, etc 57
— — statistics 57, 59
effect on character 60
what is lost by it 60
should be corrected by
glasses in children 60
as related to compulsory
education 59, 60
related to spinal curvature- 74
Necrosis from phosphorus 116
14, 18, 100
Neufchatel, statistics of distorted
Neuralgia from use of sewing-
New York, statistics of near-
Nitrogen in mines 123
Over-study, signs of. 16, 19
Over-study described 17
Over-use of organs 127-13?
Paper, tint of 56
Paris Exposition of 1878, con-
trivances to prevent accidents. 135
Piano, bad position at 64
Play, city children deprived of..
27» 38, 39
advantages of. 38
when injurious 38, 39
when inferior to gymnastics 39
Play-grounds 43, 94
Poisons and dust, effect of in-
Position in reading 55
faulty in writing, etc., as re-
lated to spinal curvature 64, 73, 74
in writing 68, 70
should be frequently varied. 70
Potassium bichromate 115
Primary schools 32
Principles of education 7-13
Print, bad 56
Private schools 98-101
Prizes to school-children 16
Professions, duration of life in 142-144
Putnam, J. J., on gymnastics 38, 40
Recesses in school 47, 62
Reading, position in 55
while sleepy 56
Regulation of hours of labor 136-141
Religion not taught by the State 8
Repair of brain and other organs 28
Rest of eyes during study 54
Restrictions on labor of women
and children 118, 119, 134, 137, 139
Rheumatism 109, 120, 124
Scheeie's green 113
School-house, site 94, 95
School-room, a model 79-84
shape, dimensions 79, 80
Schweinfurt green 113
Seats and desks 64-78
faulty construction 65,66
principles of construction 66-78
Liebreich's 67, 77
table of dimensions 76
Varrentrapp's model 75
should not be ranged in semi-
Sedentary life 131, 132
Sewerage of schools 96
Sex in education 26
Shades to windows 82
Shaftesbury, Lord, legislation.... 144
Short-sight. See Near-sight.
Sleep, loss of, a sign of over-
study 16, 19
Sleepiness after meals 21, 22
should forbid reading 56
"Slow sight" 55
Society, injurious effect on school
Spectacles. See Glasses.
Spinal distortion in girls 36, 38
at Neufchatel, etc 37
• prevented by gymnastics.... 38
Buckminster Brown on ori-
gin of. 64
related to bad position in
reading and writing 64
connected with school-seats 68
Liebreich on 74
Standing at work *3 Z
State, duty of, in education 8-10
Statistics of schools 15
of spinal deformity 37
of near-sight 57-59
of consumption from inhal-
ing dust 108, lc 9
Statistics of accidents 133
of length of life 142-144
of health of factory-hands... 140
Strain, emotional, upon pupils... 14
Study before breakfast 20
■ in the afternoon 21
antagonism between study
and meals 21, 23
interval between study and
amount of. 28-33
excess. See Over-study 28
modern methods 29
in kindergartens 29, 33
Chadwick on 29, 31
capacity for, at different
maximum average 31
at West Point 31
in colleges 32
in high-schools 32
by the half-time system 32
in kindergartens 33
in primary schools 33
with occasional rest of eyes.. 54
recesses in 62
See Education, Girls, Men-
Sulphate of quinia, manufacture
Sulphuretted hydrogen 123
Sulphurous acid produced by
burning gas 83
Sunlight in rooms 83
Tailors 129, 131
Teachers, walking exercise 35
Sabbath rest for .". 35
of gymnastics, dearth of. 40
iii London 41
in Frankfort 42
for colleges 103
Telegraph operators 129
Temperature of room 93
Theories of education 7-13
Tinting of walls 83
Trades, duration of life in... 142-144
Type 56, 57
Type-writing machine 130
Urinals for schools 96
Valves for furnace 86
Varicose veins 132
Varrentrapp on size of school-
Ventilation and heating 85-93
of closets 84
quality of air 86
by furnaces 86
by radiation 87
by steam and hot water 87
by stoves 87
auxiliary use of stove-funnel 88
by fireplace 88
— amount required 89
expense of. 90
by fan 90
by windows 91, 92
in private schools 98
of workshops 109, 118
of mines 123, 124
for women 34, 35
Walking for scholars 101
for teachers 34
Walls, tint of. 83
Washing, to protect from dust... 118
Water-closets for schools 96
Water-supply for furnaces 87
Water, heating by 87
Watson , Wm,, on accidents 133
Weakness of eyes after fevers.... 52
West Point, study at 31
should be on one side of room 80
illuminating power 80
position .. 81
collective size 82
ventilation by 91
■ in private houses 98
Women, exercise for 34, 35
■ — — special susceptibility to poi-
legal restraint on labor
"8, 134, 137-139
standing in shops 132
Woodbury's pen-holder 129
Work, proper amount of mental . 10
Worry of mind 123
Writer's cramp 128, 129
Writing as connected with
crooked spine 37
large hand 57
position ia 64, 68, 70
Zwez on size of school-room 79
Catalogue No. 5. FEBRUARY, 1896.
BOOKS m NURSES.
FOR NURSES AND ALL ENGAGED
IN ATTENDANCE UPON THE SICK,
OR THE CARE OF CHILDREN.
Dealing exclusively in books on medicine
and collateral subjects, we are able to give special
attention to supplying books for nurses. We have
a large stock of works on Nursing, Hygiene,
Popular Medicine, etc., Temperature Charts, etc.
Catalogues of Books on Medicine, Dentistry,
Pharmacy, Chemistry, etc., free, upon application.
Special attention given to orders to be forwarded
to a distance, by mail or express. Upon receipt of
the price, any book will be delivered, free, to any
address. Money should be forwarded by Post-
Office Order, Draft, or Registered Letter.
P. Blakiston, Son & Co.,
1012 WALNUT STREET, PHILADELPHIA.
* :.; The p r ices as given in this catalogue are net.
No discount can be allowed retd*;l purchasers.
Hygiene of the Nursery
INCLUDING THE GENERAL REGIMEN AND FEEDING OF INFANTS
AND CHILDREN AND THE DOMESTIC MANAGEMENT
OF THE ORDINARY EMERGENCIES OF
BY LOUIS STARR, M. D.,
Clinical Professor of Diseases of Children in the Hospital of the University
of Pennsylvania; Physician to the Children's Hospital, Phila.
Fourth Edition. Enlarged and improved.
WITH TWENTY-FIVE ILLUSTRATIONS.
i2mo. 280 Pages. Cloth, $1.00.
*■..* This book contains very complete directions for the proper
feeding of infants: 1st, From the maternal breast. 2d. By wet-
nur^e, including rules for choosing the woman. 3d, Artificial
Feeding. This part of the subject is elaborated carefully, so as to
include everything of importance, and will be found of great service
to the monthly nurse. General and specific rules for feeding are
given, and Diet Lists from the first week up to the eighteenth
month, with various recipes for artificial foods, peptonized milk, etc.
Directions for the sterilization of milk, substitutes for milk, prepara-
tion of food for both well and sick children, nutritious enemata.
etc., and the general management of the Nursery.
" Dr. Starr's experience as Clinical Professor of Diseases of Children in the
University Hospital and as physician to the Children's Hospital, with his
eminence in private practice among juvenile patients, is ample warranty for the
satisfaction and instruction to be found in this book. The dedication "To my
Little Patients," shows the sympathy with which the writer enters upon the
important discussion. The volume is entirely in the modern lines of preventive
medicine — more important in the nursery than at any other time of life ; because
constitution building is going on then and there. In this admirable treatise, so
clearly written that no mother need be deterred by fear of medical terms from
making its teaching her own, Dr. Starr carries out the highest ideal of the
modern physician, so to regulate the lives of his professional clients that the
occasions are less frequent when he need be called in to act for serious compli-
cations. * * * * With the numerous good treatises on the subject that
Phdadelphia publications include, this intelligent work is the most distinguished,
as it is also the latest work on complete Hygiene of the Nursery." — The Led-
MANUAL OF NURSING.
MEDICAL AND SURGICAL.
A complete Text-Book for Nurses, including General Anatomy
and Physiology, Management of the Sick-Room, Appliances used
in Sick-Room, Antiseptic Treatment, Bandaging, Cooking for
Invalids, etc., etc.
Thirteenth Edition. With 70 Illustrations.
BY LAWRENCE HUMPHREY, M.A., M.D.
12MO. CLOTH. PRICE $1.00.
St. Joseph's Hospital,
Seventeenth and Girard Avenue,
Philadelphia, March 15, 1393.
Messrs P. Blakhton, Son &* Co. : —
Please send us six more copies of Manual of Nursing, by Humphrey. We
do not know of any book that more completely meets the requirements of a
Training Class than Dr. Humphrey's able Lectures, for they are at once clear,
concise, and thoroughly practical. Sisters of Charity.
From British Medical Journal, London.
11 Nursing literature is expanding, and, what is more to the purpose, it shows
manifold signs of improvement with its growth. In the fullest sense, Dr.
Humphrey's book is a distinct advance on all previous manuals. It is, in point
of fact, a concise treatise on medicine and surgery for the beginner, incorporat-
ing with the text the management of childbed and the hygiene of the sick-room.
Its value is greatly enhanced by copious wood-cuts and diagrams of the bones
and internal organs, by many illustrations of the art of bandaging, by tempera-
ture charts indicative of the course of some of the most characteristic diseases,
and by a goodly array of sick-room appliances, with which every nurse should
endeavor to become acquainted. . . . The systematic arrangement of
subjects adopted by the author is excellent."
THE BEST GENERAL TEXT-BOOK.
DISEASES OF WOMEN.
A Series of Lectures Delivered to the Pupils of the Training School
for Nurses Connected with the Woman's Hospital of
Philadelphia, comprising their Regular Course
of Instruction on such Topics.
BY ANNA M. FULLERTON, M.D.,
Physician-in-Charge of and Obstetrician and Gynaecologist to the IVoman's
Hospital of Philadelphia, etc.
SECOND EDITION, REVISED.
12mo. 300 Pages. 70 Illustrations. Cloth, $1.50.
***The immediate success of Dr. Fullerton's " Handbook of
Obstetric Nursing,'' a fourth edition of which has just been pub-
lished, has encouraged her to prepare this manual on another and
very important branch of the science and art of nursing. Dr.
Fullerton has demonstrated that she nol only knows what to say,
but that she has the happy faculty of saying it in a plain, practical
style that interests as well as instructs.
Synopsis of Contents. — The Surgical Nurse — The Germ Theory
of Disease — Asepsis and Antisepsis — Abdominal Section — The Pre-
paration of the Room — The Preparation of Sponges — Sterilization
of Instruments, etc. — Preparation of the Patient — Preparation of
Operator and Assistants — The Nurse's Duties During Operation —
The Nurse's Duties After Operation and During Convalescence —
Management of Complications — The Pelvic Organs in Women —
Diseases of Women — General Nursing in Pelvic Diseases — Pre-
parations for Gynaecological Examinations — Preparation for Gynae-
cological Operations— Preparation of Patient, Operator and Assist-
ants — Duties of Nurse During Operation — Special Nursing in
Gynaecological Operations — Diet for the Sick — Supporting Treat-
ment of Abdominal Sections — Index.
Comprising the Course of Instruction in Obstetric Nursing
given to the Pupils of the Training School for Nurses
connected with the Woman's Hospital of Philadelphia.
BY ANNA M. FULLERTON. M.D.,
Demonstrator of Obstetrics in the Woman's Medical College of Pennsyl-
vania: 1'hys cim-in- Charge and Obstetrician and Gynecologist to the
Woman's Hospital of Philadelphia, and Superintendent of the
Nurse Training School of the Woman' s Hospital of Philadelphia.
40 Illustrations. 12mo. Handsome Cloth, $1.00.
FO UR TH EDITION— RE VISED.
Synopsis of Contents —The Pelvis and Genital Organs-
Signs of Pregnancy — Management of Pregnancy— Accidents of
Pregnancy — Germs and Antisepsis— Application of Antisepsis to
Confinement Nursing — Preparations for the Labor — Signs of
Approaching Labor and the Process of Labor — Duties of the Nurse
during Labor— Accidents and Emergencies of Labor— Care of the
New-born Infant — Management of the Lying-in — Characteristics of
Infancy in Health and Disease — The Ailments of Early Infancy —
" It is a book that I have recommended since I first saw it, and we are using
it for our nurses at the N. Y. Infirmary, wheie we have a branch of our School,
our nurses going there for instruction in obstetrics." — Mrs. L. W. Quintard]
Supt. Connecticut Training School for Nurses, New Haven, Conn.
"It is the most modern and complete book I have ever read for the care of
obstetrical patients. I shall take pleasure in recommending it to this school for
study."— E. L. Warr, Supt. Training School for Nurses, City Hospital, St.
" I have looked it over and read it with care, and think it is the best book I
have ever seen on the subject. It is practical, with plain instructions, nothing
superfluous. A good book for nurses and teachers of nurses." — Miss Anna
G. Clement, Supt. of Nurses, The Henry W. Bishop Memorial Training
School for Nurses, Pittsfield, Mass.
" I consider the book excellent in every particular. Would recommend it to
every nurse, whether she did obstetrical nursing or not." — Gertrude Mont-
port, Supt of Nurses, Nezv England Hospital for Women and Children,
" What is to be learned in a maternity training school is the way to nurse as a
profession. * * * Can recommend it as a valuable manual." — From the Amer*
ican Journal of Medical Sciences.
BOOKS ON NURSING.
VOSWINKEL. Surgical Nursing, a Manual for
Nurses and Students, including Complete Chapters
on Bandaging, Dressings, Splints, etc. By Bertha
M. Voswinkel, Graduate of the Episcopal Hospital,
Philadelphia; Nurse in Charge of Children's Hos-
pital, Columbus, Ohio. With in Illustrations. 121110.
168 pages. Cloth, $1.00
SHAWE. Notes for Visiting Nurses, and all
those Interested in the Working and Organization of
District, Visiting, or Parochial Nurse Societies. By
Rosalind Gillette Shawe, District Nurse for the
Brooklyn Red Cross Society. With an Appendix
explaining the Organization and Workings of various
Visiting and District Nurse Societies, by Helen C.
Jenks, of Philadelphia, nmo. Cloth, $1.00
CULLINGWORTH. A Manual of Nursing,
Medical and Surgical. By Charles J. Cul-
lingworth, m.d., Physician to St. Mary's Hospital,
Manchester, England. Third Edition. With 18
Illustrations. j2mo. Cloth, .75
by the same author.
A Manual for Monthly Nurses. Third Edi-
tion. 321T10. Cloth, .40
"This small volume is written as a supplement to the author's well-known
work on nursing. It treats only of the conditions of pregnancy and labor. It
is clear in its statements, and will prove of great value to those whose duty it
is to care for women during and after confinement." — N. Y. Medical Journal.
DOMVILLE. Manual for Nurses and Others
Engaged in Attending to the Sick. By Ed. J. Dom-
ville, m.d. Seventh Edition. With Directions for
Bandaging, Preparing and Administering Enemata,
Fomentations, Poultices, Baths, etc., Recipes for
Sick-room Cookery, Tables of Weights, and a Com-
plete Glossary of Medical Terms. Cloth, . 75
BOOKS ON NURSING.
CANFIELD. The Hygiene of the Sick-Room.
A Book for Nurses and Others, being a Brief Consid-
eration of Asepsis, Disinfection, Bacteriology, Im-
munity, Heating and Ventilation, and Kindred Sub-
jects, for the use of Nurses and Other Intelligent
Women. By Wm. Buckingham Canfield, a.m.,
m.d., Lecturer on Clinical Medicine, and Chief of
Chest Clinic, University of Maryland, Visiting Phy-
sician to Bay View Hospital, etc. i2mo. 247 pages.
Handsome Cloth Binding, #1.25
*#* This book is the outcome of a series of lectures delivered by
Dr. Canfield at the University of Maryland Training School for
Nurses. It contains much valuable information not included in the
regular text-books, but which of necessity the nurse should be ac-
" We recommend it to the attention, not only of sick-nurses, but also all other
persons, of either sex, who desire a knowledge of the behavior of disease, as it
concerns infection ; and the manner in which foulness, either of wounded sur-
faces, or of the sick-room, or of the dwelling-house, may be prevented.
" Each disease is taken up in turn (typhoid fever, consumption, diphtheria,
etc.) and the methods of management of the discharges, etc , are described in
detail. The formulae for the preparation of disinfecting solutions, for clothing,
utensils, privies, etc., are clearly set forth; such details as one may search his
library in vain for are here given in a compact form.
" The prevention of blindness in infants receives lull attention. Ventilation
is duly considered, and a chapter is given to the thoughtful discussion of immu-
nity and protection from disease. The book closes with some remarks upon
the diet of the sick-room. We congratulate Dr. Canfield on his work. It is
well worth the moderate price.'' — Maryland Medical Journal.
GRAPHIC CLINICAL CHART. Designed by
J. P. Crozer Griffith, m.d. The purpose of this
chart is to give, in the most concise form, a complete
record of pulse, respiration, and temperature of the
patient. Its simplicity and the ease with which it is
kept commend it to nurses, and the clearness of the
design makes plain at a glance the full history of the
case. Price, in packets of 50, .50
BOOKS ON MASSAGE.
KLEEN. Handbook of Massage. Cloth, $2. 25
By Dr. Kleen, of Stockholm and Carlsbad. Translated
by Edward M. Hartwell, a.m. m.d., Director of Physi-
cal Education, Boston Public Schools, late of Johns Hop-
kins University, Baltimore. With an introduction by S.
Weir Mitchell, m.d., of Philadelphia. Illustrated by a
series of Handsome Engravings, made from fine Pen-and-
ink Drawings after original photographs made for the pur-
pose. *** This is the American Edition of "Kleen's Hand-
book,'' which is well known among teachers and experts
as the most comprehensive and perfect on the subject.
Several changes and additions have been made at the
author's suggestion, notably among the latter the set of
illustrations made from photographs taken by him for this
edition. No pains have been spared to make this the best
of standard works upon massage.
MURRELL. Massotherapeutics. Fourth Edi-
tion. Or Massage as a Mode of Treatment. By Wm.
Murrell, m.d., f.r.c.p., Lecturer on Pharmacology and
Therapeutics at Westminster Hospital, Examiner at Uni-
versity of Edinburgh, Physician to Royal Hospital for Dis-
eases of the Chest. Fifth Edition. Revised and Enlarged.
Illustrated. i2mo. Cloth, 1.25
" Dr. Murrell particularly dwells on the importance of discrimination in the
selection of cases and on the special qualifications of a competent manipulator.
In a word, this essay may be said to convey in a short space most of the infor-
mation that is at present available in regard to this popular therapeutic agent. "
— From the London Practitioner.
" This little volume sets forth clearly all the advantages and disadvantages
of massage at the present day, and should be in the hands of every Masseuse
or nurse intending to take up the art. The numerous illustrations of the move-
ments will prove a great aid. " — From the Trained Nurse .
OSTROM ON MASSAGE.
Massage and the Original Swedish Move-
ments. Illustrated. And Their Application to
Various Diseases of the Body. A Manual for Students,
Nurses, and Physicians. By Kurre W. Ostrom,
from the Royal University of Upsala, Sweden ; In-
structor in Massage and Swedish Movements in the
Hospital of the University of Pennsylvania and in
the Philadelphia Polyclinic and College for Graduates
in Medicine, etc. Illustrated by ninety-three ex-
planatory Wood Engravings. Third Edition, Revised
and Enlarged. 121110. Cloth, $1.00
" Mr. Ostrom presents to the English public this excellent, systematic manual,
showing, by illustrations, the various movements and the mode of application to
all parts of the body. The writer tells for what diseases such movements are
indicated, with some remarks on the physiology of the movement treatment."
— From The Philadelphia Public Ledger.
" In this volume the author gives an excellent description of the methods of
massage and Swedish movement, together with their applicability to various
diseased conditions of the body. The methods are rapidly becoming popular-
ized in our own country, and the perusal of such a book as Mr. Ostrom has
written will be of great advantage to physicians, for whose use it is mainly in-
tended."— From the Journal of the American Medical Association.
4* Our author has performed a useful service in publishing this
brief and clearly written manual, and we can recommend it to all who wish to
gain a knowledge of a method of procedure which is daily finding more favor
in professional circles. The price of the volume should also insure it a wide
circulation."— From the Edinburgh Medical Journal.
"The descriptions are clear, and so well supplemented by the illustrations,
that anyone with this book, and a subject on which to practice, could undoubt-
edly become proficient in the art of massage. An excellent feature is the simple
classification of the manipulations adopted by the author, which makes the
whole subject much easier to grasp. "—From the Medical News, Philadelphia.
ANATOMY A ND P HYSIOLOGY.
POTTER'S Anatomy. Fifth Edition. 117
Illustrations and 16 Lithograph Plates. A
Compend of Human Anatomy. By Saml. O. L.
Potter, m.a., m.d., m.r.c.p. (Lond.), Professor of
the Practice of Medicine, Cooper Medical College,
San Francisco. 121110. Cloth, .80
" This is, in its way, a wonderful little book, comprising within its pages z.
more or less complete account of every part of the human body, not even omit-
ting the histology of the tissues and organs." — Edinburgh Medical Journal,
" Contains many useful hints and aids to memory not found in ordinary
works." — Canada Lancet.
" The arrangement is well calculated to facilitate accurate memorizing, and
the illustrations are clear and good." — North Carolina Aledical Journal.
BRUBAKER'S Physiology. Seventh Edition,
Enlarged and Improved. Illustrated. A Com-
pend of Physiology, including Embryology. By
A. P. Brueaker, m.d., Demonstrator of Physiology
at Jefferson Medical College ; Professor of Physiology,
Pennsylvania College of Dental Surgery, Philadelphia.
28 Illustrations. 121110. Cloth, .80
" This is an admirable compend of physiology, including enough of anatomy
to fit it especially for the use of students of medicine. It has been prepared by
one who is fully fitted by his work as Demonstrator in the Jefferson Medical
College, and as Professor of Physiology in the Pennsylvania College of Dental
Surgery, and by his experience as quiz-master, to compile such a book, and it
has proved its utility by the acceptance it has already found. Its style is
clear and distinct, its teachings are sound, and it is well suited to the
purpose for which it is intended." — Medical and Surgical Reporter.
MATERIA MED1CA AND THERAPEUTICS.
POTTER'S Materia Medica, Therapeutics,
and Prescription Writing. Sixth Edition.
Compend of Materia Medica, Therapeutics, and Pre-
scription Writing. With special reference to the Phy-
siological Action of Drugs. By Samuel O. L. Potter,
m.a., m.d., m.r.c.p. (Lond.), late A. A. Surgeon,
U. S. Army ; Professor of the Practice of Medicine,
Cooper Medical College, San Francisco. i2mo.
BOOKS FOR NURSES.
HORWITZ'S Surgery. Minor Surgery and
Bandaging. Fifth Edition. 167 Illustrations.
A Compend of Surgery, including Minor Surgery,
Amputations, Fractures, Dislocations, Surgical Dis-
eases, Antiseptic Rules, Formulae, etc., with Differen-
tial Diagnosis and Treatment, and a Complete Section
on Bandaging. By Orville Horwitz, b.s., m.d.,
Professor of Genito-Urinary Diseases; late Demonstra-
tor of Surgery, Jefferson Medical College, etc. Fifth
Edition. 324 pages. 121110. Cloth, .80
*x* The new Section on Bandaging and Surgical Dress-
ings consists of 34 Pages and 40 Illustrations. Every
Bandage of any importance is Figured.
WYTHE'S Dose and Symptom Book. The
Physician's Pocket Dose and Symptom Book. Con-
taining the Doses and Uses of all the Principal
Articles of the Materia Medica, and Officinal Prepa-
rations. By Joseph Wythe, a.m., m.d. Seventeenth
Edition; revised and rewritten, containing Tables of
Weights and Measures, Rules for Proportioning the
Doses of Medicines, Hints on Treatment, etc.
Cloth, .75; Leather, with Tucks and Pocket, $1.00
WESTLAND. The Wife and Mother. A
Medical Guide to the Care of her Health and the
Management of her Children. By Albert West-
land, m.d. 121110. Illustrated. Cloth, $1. 50
From the Philadelphia Medical News.
" A noticeable point about this little volume is the commendable absence of
technical terms, as the author plainly states that it is for the use of ' women who
are desirous of fulfilling their proper duties of wives and mothers.' Too often,
in works of this class, the readers for whom they are intended are confused and
led astray by the multiplicity of words and phrases meant rather for the prac-
titioner than the mother. . . . Altogether the books fulfills ihe objects for
which it was written, and will materially assist the young married woman in
the intelligent performance of new duties."
From the Nurse, Boston.
" The style is easy and fascinating. It should be in the hands of every nurse
and married women."
ACCIDENTS and EMERGENCIES.
A Manual for the treatment of Surgical and other Injuries,
Poisoning and various Domestic Emergencies, in the absence of the
By CHARLES W. DULLES, M.D.,
Surgeon to the Out-Door Department of the University and Presbyterian
Fourth Edition, Enlarged. New Illustrations. 12mo. . ■
SHORT LIST OF CONTENTS.
Obstructions to Respiration.
Foreign Bodies in the Eye, Nose and
Fits or Seizures.
Injuries to the Brain.
Effects oi Heat.
Effects of Cold.
Wounds of all kinds, including the
bites of Dogs, Cats, Snakes, Insects,
Railroad and Machinery Accidents.
Hemorrhage — Bleeding.
Transportation of the Injured.
Poisons and their Antidotes.
Domestic Emergencies, includes Chol-
era Morbus, Vomiting, Diarrhoea,
Nervous Attacks, Earache, Tooth-
ache, Asthmatic Attacks, Croup,
Signs of Death.
Supplies for Emergencies.
The Surgical and Medicine Case,
their contents and use, Bandaging,
*** This book should be in the possession of every head of a
family, Nurse, Manufacturer, Police Lieutenant, Sea Captain, Hos-
pital Steward, School Teacher, Druggist, etc. etc.
" Several attempts have been made to prepare a volume which would serve
as a handy manual for reference in the time of need, in the absence of a doctor,
but none have succeeded better than the present little work. It should be in the
hands of all officers charged with the public conveyance of passengers, to be
read, in preparation for emergencies, and afterward to serve as a book of refer-
ence." —North Carolina Medical Journal,
"This little manual contains simple directions for the preliminary treatment
of accidents to all parts of the body and of such diseases as persons are suddenly
seized with. Without profuseness or an unintelligible vocabulary, it contains in
a small space a deal of useful information." — New York World.
" This is a revised and enlarged edition, with new illustrations, of the manual,
explaining the treatment of surgical and other injuries in the absence of the phy-
sician. The simple and practical suggestions of this little book should be known
to every one. Accidents are constantly occurring, and a knowledge of what
should be done in an emergency is very valuable. Such -\ handbook should be
in every home, placed where it can always be found readily. — Boston Journal
11 1 may say that Dr. E. P. Davis' Manual has proved useful to me
in teaching obstetrics by its clearness and its many practical sugges-
tions."— MARION E. SMITH, Chief Nurse Philadelphia Hospital.
DAVIS. Manual of Practical Obstetrics. By
Edward P. Davis, a.m., m.^.j Clinical Lecturer en Obstet-
rics in the Jefferson Medical College, Professor of Obstetrics
and Diseases of Children in the Philadelphia Polyclinic,
Visiting Obstetrician to the Philadelphia Hospital. Second
Edition, Enlarged. 351 pages; 150 illustrations, several
of which are colored. Cloth, $2.00
** I have carefully reviewed the * Manual of Obstetrics ' by Dr. E. P. Davis.
" It is full, accurate, concise, and gracefully and clearly written. It is a most
excellent Manual of the art it teaches." — Prof. J. Snydam Knox, Rush
Medical College, 22jy Calumet Avenue, Chicago.
" I have read it with interest, and consider it one of the best works on the sub-
ject for the use of students and practitioners. " — Dr. James P. Boyd, Albany
Medical College, Albany, N. Y.
'* I am so well pleased with the work that I have recommended it to my class. "
— Dr. A . L. Breysacher, Medical Department A . / U. r Little Rock, A rk.
" I have completed my examination of it, and want to say that I think it is
the biggest little work on the subject it has been my privilege to look over. It
is surely a complete work, devoid of theory, replete with practice. I heartily
commend it as a manual. " — Dr. J. R. Rathmell , Chattanooga Medical College,
" I would say that in style and character it is abreast with the most modern
and approved methods and thought upon the subject, that for brevity it is clear,
systematic, and concise, very suitable for the busy student during the session .it
college, and for the busy practitioner as well. Itgives the essentials, and I shall
take pleasure in recommending it to my students." — Dr. M. R. Mitchell, Kan-
sas Medical College, Topeka, Kan.
"It is especially clear and pleasing in style and the subject matter is well
chosen. It is a good text-book. " — Dr. Clara Marshall, Philadelphia.
" It is concise and accurate, and I cordially recommend it as admirably suited
to the convenience of the medical student and busy practitioner. "—Dr. De
Laskie Miller, Rush Medical College, Chicago, III.
" I consider it a very good book. " — Pro/. A -F. A. King, National Medical
College, Columbian University, Washington, D. C.
" I consider it a valuable work, especially for the recent graduates who are
entering upon the practice of obstetrics and pursuing post-graduate studies.
" I keep my copy where I can read it, and consult its pages almost daily, and
generally find what I want in a few lines." — Dr. P. C. Claybetg, American
Medical College, St. Louis, Mo.
" The book appears to me to meet the purposes for which it is written and to
he a valuable addition to the library of the busy practitioner. " — Pro/. Randolph
Window, University of Maryland, Baltimore, Md.
" I am well pleased with the 'Manual of Obstetrics' by Dr. E. P. Davis,
andean recommend the work to the profession."— Pro/. C. A. Pauly, Pulte
Medical College, Cincinnati, O.
" The book is a most excellent one. After careful investigation, I have no
hesitation in cordially recommending it to anybody in need of a small manual."
—Dr. M. D. Mann, Buffalo, N. Y.
American Health Primers.
EDITED BY W. W. KEEN, M.D.,
Professor of Surgery in the Jefferson Medical College, Fellow of the College
of Physicians of Philadelphia, etc.
12 Vols. 32mo. Attractive Cloth Binding, each 40 Cents.
This Series of Health Primers is prepared to diffuse as widely and
cheaply as possible, among all classes, a knowledge of the elementary facts of
Preventive Medicine, They are intended incidentally to assist in curing dis-
eases, and to teach people how to form correct habits of living, and take care
of themselves, their children, employees, etc.
I. HEARING AND HOW TO KEEP IT. With Illustrations. By Chas.
H. Burnett, m d., of Philadelphia, Aurist to the Presbyterian Hospital.
II. LONG LIFE AND HOW TO REACH IT. By J. G. Richardson, m d ,
of Philadelphia, late Professor of Hygiene in the University of Pennsyl-
III. THE SUMMER AND ITS DISEASES. By James C. Wilson, m.d ,
of Philadelphia, Professor of the Practice of Medicine, Jefferson Medical
IV. EYESIGHT AND HOW TO CARE FOR IT. With Illustrations. By
George C. Harlan, m d., of Philadelphia, Surgeon to the Wills (Eye)
V. THE THROAT AND THE VOICE. With Illustrations. By J. Solis
Cohen, m.d. , of Philadelj. hia, Lecturer on Diseases of the Throat in Jef-
ferson Medical College, ami on the Voice in the National School of Oratory.
VI. THE WINTER AND ITS DANGERS. By Hamilton Osgood, m.d.,
of Boston, Editorial Staff Boston Medical and Surgical Journal.
VII. THE MOUTH AND THE TEETH. With Illustrations. By J. W.
White, m.d , d.d.s., of Philadelphia, Editor of the Dental Cosmos.
VIII. BRAIN WORK AND OVERWORK. By H . C. Wood, Jr., m.d ., of
Philadelphia, Clinical Professor of Nervous Diseases in the University of
IX. OUR HOMES. With Illustrations. By Henry Hartshornb m.d ,
of Philadelphia, formerly Professor of Hygiene in the University of Penn-
X. THE SKIN IN HEALTH AND DISEASE. With Illustrations. By
L. D. Bulkley, m.d., of New York, Physician to the Skin Department
of the New York Hospital.
XI. SEA AIR AND SEA BATHING. With Illustrations. By John H.
Packard, m.d., of Philadelphia, Surgeon to the Pennsylvania Hospital.
XII. SCHOOL AND INDUSTRIAL HYGIENE. By D. F. Lincoln, m.d.,
of Boston, Mass., Chairman Department of Health, American Social
" The series of 'American Health Primers" deserves hearty commendation.
These handbooks of practical suggestions are prepared by men whose profes-
sional competence is beyond question, and, for the most part, by those who
have made the subject treated the study of their lives." — Ne7u York Sun.
*>* Each Volume 50 Cents, in Attractive Cloth Binding.
MANUAL OF GYNECOLOGY
Two Hundred and Thirty-four Illustrations.
By Henry T. Byford, m.d., Professor of Gynecology
and Clinical Gynecology in the College of Physicians
and Surgeons of Chicago ; Professor of Clinical Gyne-
cology in Woman's Medical School of Northwestern
12mo. 488 Pages. Cloth, $2.50.
Though prepared more especially for medical stu-
dents and young physicians, this book has many
points that recommend it to the nurse who wants
to thoroughly understand the important details of
The chapters in Part One on gynecological tech-
nique and the principles of gynecological treat-
ment are more minute in detail than is usual in
such books, special attention being given to the
duties of the nurse, to aseptic and antiseptic mat-
ters, instruments, etc., etc. A series of eight illus-
trations showing the various postures in which the
patient is placed for examination or operating will
GOULD'S POCKET MEDICAL LEXICON.
12,000 MEDICAL WORDS
PRONOUNCED AND DEFINED.
A Pronouncing Lexicon of Medical Words Specially Adapted for
Nurses, Including Many Useful Tables and a Dose List.
BY GEORGE M. GOULD, M.D.,
Author 0/ "An Illustrated Dictionary of Medicine, Biology, and Allied
Sciences," " The Student's Medical Dictionary," etc.
Pocket Size. 317 Pages. Gilt Edges, Full Morocco.
Price $1.00; with a Thumb Index, $1.25.
OVER 47,000 COPIES OF GOULD'S DICTIONARIES
HAVE BEEN SOLD.
" Gould's Dictionary, Pocket Edition, is the most complete and convenient I
have seen." — Marion E. Smith, Head Nunc, Philadelphia Hospital, Phila.
"The Pocket Dictionary is a little gem." — L J. Gross, Head Nurse , Buffalo
" I have examined Gould';. Dictionary, and consider it the best dictionary in
a small compass that I have seen. The price, too, is most reasonable I shall
recommend it to all our nurses." — F. Hutcheson, J lead Nurse, Flower Mission
Training School for Nurses, Indianapolis, Ind.
" 1 shall certainly have the nurses each send for a copy of the dictionary. It
is just what they need, and is a nice size to carry. " — Harriet Sutherland, Head
Nurse, Margaret Pillsbury Hospital, Concord, N. H
#5" Every nurse should have a copy of this little book in order
to intelligently pursue her studies and to thoroughly understand
the physician's directions. It fur n'^immmm^mmgmmmmm^^l inform a
tion not to be obtained in the res<;lar text-books. ^^V^
Llbrao Bureau Cat. No. 1137